Facebook dilemma

Nurses General Nursing

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The problem I have with fb is that I am friends with supervisors and peers at work, and therefore can't rant about work.

Which is all this amounts to. I work in LTC where management posted the following notice to nurses. "Do not call the doctor for orders to transfer residents to the hospital.without calling the Don or Adon We can and should treat them in house."

So here are my problems with this: I am in the building and you Don/Adon are not. So you don't know what I am finding on my assessment that prompted my call to the doctor. Also though absolutely we can treat residents in house, is it best for the pt? One nurse 20 patients, no RT no Md in house VS one nurse and 8 patients, RT, Md and onsite xray and lab results and a pharmacy. Which setting would be best for the patient with acute health problems? Plus who will be liable if the patient treated in house has a bad outcome? I am betting it would be me the nurse who did not call the doctor. I don't say, "Hey I want to send this pt to the ER". I just present assessment data, code status and ask the doctor what he would like me to do. Lots of times it will be order these labs/xrays , start this med, etc. I feel like management in there concern for census is not serving patients, nurses or doctors well.

Plus it just kind of says we don't trust your nursing judgement.

Specializes in ICU.

I have but a tiny number of facebook "friends," and I NEVER talk about work. Our administration regularly checks their employees facebook accounts (yes, they do!) and you will be fired if you talk about the hospital. I care more about my job (that pays my bills and feeds me) than I do about my facebook account. Just do your venting on allnurses.

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You can set your posts to be seen by only those who you want to see them.

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I have but a tiny number of facebook "friends," and I NEVER talk about work. Our administration regularly checks their employees facebook accounts (yes, they do!) and you will be fired if you talk about the hospital. I care more about my job (that pays my bills and feeds me) than I do about my facebook account. Just do your venting on allnurses.

Stories like this is why I have paranoid security settings on FB.

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You can have two facebook accounts...one for your "junk" friends and coworkers and one using only your first and middle name or an alias for your real, close friends and family who you'd like to be able to post "real" stuff with, and then still be super careful. Also, make sure you know which account you are logged in through when you post!!!!

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Still trying to figure out why anybody would post anything about work on a social web site...

I work in LTC where management posted the following notice to nurses. "Do not call the doctor for orders to transfer residents to the hospital.without calling the Don or Adon We can and should treat them in house."

Was this posted on Facebook (hence, the merging of Facebook and when to call the doctor)?

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I am so confused. Is this about venting on FB or calling the ADON when a patient may need to be transferred?

Of course be careful on FB whether venting about your cousin Sue or your place of work.....DUH.

As to calling the ADON if a patient may need to be transferred out honestly I don't see a problem. Unless it is a call 911 emergency, a few minutes to call the ADON shouldn't be an issue. It is even possible they might possibly (wait, I hope you are sitting down) know something about the patient, their condition, their family, and doctor. It is possible they would say "Oh Dr. X already knows about that, he discussed it with the family, they are treating it conservatively."

Hopefully most of the time within reason they will simply say "Okay, thanks for letting me know, send them to the hospital." If you run into too frequent. "No, do not send them I don't think they need to go." Then you may have a real problem to deal with.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

The Commuter i right...it is ALL about the money.

Don't complain about work on FB.....not a good policy in general. I'm for keeping work and home separate as much as possible. Follow the policy the best you can.....but if the patient need 911...call 911.

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Specializes in Gerontology, Med surg, Home Health.

Rhi007...I am in management. I was not born into the position. I held and was successful at every position in long term care. I can most likely run circles around you on a subacute floor.That said, I trust most of the nurses who work for me. If they think the resident needs to go and they've tried everything they can in the facility, the patient goes to the hospital. End of story. If they are clueless as to how to treat CHF then I encourage them to use the tools I've given them or they feel free to call me at home for advice. i do know what's going on with my 160 residents since I make it my business to know.The OPs dilemma has absolutely nothing to do with Facebook.

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Why are you even on facebook once you have a job all of that stuff should be CUT OFF. It can get you fired regardless.

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Rhi007...I am in management. I was not born into the position. I held and was successful at every position in long term care. I can most likely run circles around you on a subacute floor.That said I trust most of the nurses who work for me. If they think the resident needs to go and they've tried everything they can in the facility, the patient goes to the hospital. End of story. If they are clueless as to how to treat CHF then I encourage them to use the tools I've given them or they feel free to call me at home for advice. i do know what's going on with my 160 residents since I make it my business to know.The OPs dilemma has absolutely nothing to do with Facebook.[/quote']

You are in the minority, I know CN's and NM's that sit in their offices and do nothing but the administrative stuff, don't know what is happening on the ward, the hospital even and if you had read any if my previous posts you would know that you would run rings around me in subacute care .......I'm not a nurse yet!! I volunteer in an ED

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When you said management "posted" this notice, I am assuming it was at your place of employment and not on facebook...

Essentially, what this looks like to me is that they are no longer letting nursing in house make transport decisions. I would ask for more clarification. If the patient needs say a cough surpressant, you call the MD expecting that you are going to get an order for one, and the MD says "lets get a chest xray" then what? So sorry MD we are not allowed to do that without the DON permission? What the notice seems to be saying is that the DON/ADON will be the ones to communicate with the doctors after you call DON/ADON with your assessment. This can be a slippery slope for you in documentation, so document accordingly. And ask about rapid transfers for your full code patients. If they are going to institute this policy, then they need to be in house on the off shifts. I am sure that no one wants to make that 3am call "ok, you take over chest compressions, I need permission to call 911"....... If they are making such a major practice change, then you need to make sure you are covered, especially if you are charge on the off shifts.

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Specializes in geriatrics.

As far as work is concerned, there should be no dilemma about facebook ever. Don't friend many coworkers (if at all....I've friended one coworker and I monitor their posts....) And don't discuss any details pertaining to work. If you follow these rules, facebook can be a very useful tool.

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