Things that make you go hmmm...Nurse on Twitter?

Nurses General Nursing

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I'm not sure about something I just stumbled across, but don't wish to start a heated argument- or attack this nurse- just gain some perspective.

I follow a D-list (not Kathy Griffin) "celebrity" on Twitter, who just asked her followers to follow a person battling cancer. Apparently, one of her wishes is to have 5,000 followers, so I clicked "follow" to help her out & offer my good wishes.

There are lots of posts for wishes for her recovery- which doesn't look great- but there are also many, many, many posts from her nurse, "B," updating her followers on her condition fairly regularly- including her fever/body temperature, state of consciousness and comments like, "her heart stopped beating (this morning)...but we got her back up" and "it's 'B," not 'X,' and she's honestly not doing good (sic)." Since it's the internet, and anonymous, I'm not 100% sure this person is her nurse, but has identified themselves as so on her feed, and is giving hourly updates on this patient's condition. The nurse identifies himself/herself in every post, so it's clear it's not the account holder. To add to the confusion, there also seems to be a back story (no family involved, estrangement, etc.)

Has a terminally ill patient ever asked you to post their condition on the internet to keep their friends informed on their behalf? What would you do? Is there a policy in your hospital against this?

I'm sure you can tell, I'm uncomfortable with this, but with the rapid advancement of technology, is this how things are progressing? Is this ethical?

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Specializes in Cardiothoracic ICU.

Should be fine as long as this is the patients wishes.

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If the nurse has her permission, then nothing illegal has transpired.

However, if it was me, I would not do it. I'd designate a family member or someone else. Too much potential liability should a family member get upset. At the minimum, I'd get the patient to sign a document stating that she has given me permission to access her twitter account and post updates about her condition.

But, that's just me. Very likely, it isn't a nurse, just someone who styles themselves as such.

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Call me a skeptic, but the thought crossed my mind that this could be a fabrication. It wouldn't be the first time that someone posted a dramatic "story" and drew others into a caring group.

This wouldn't necessarily be a malicious or intentionally deceitful thing to do. It might just be a fumbling attempt to "create" a story or find a purpose for people to connect with.

If it is true, I hope the "nurse" does have some kind of disclaimer from the patient. Just because there is no family involvement now doesn't mean they won't come forward at some future time.

Hard to say which possibility I would root for.

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Specializes in Peds/outpatient FP,derm,allergy/private duty.

It does sound "iffy" to me as well. There have been way too many hoax cancer patients to make me take anything at face value anymore, and unfortunately sometimes the real deal gets caught in the net of suspicion.

If the patient is in the hospital, I cannot imagine that they would OK one of their employees to do updates on Twitter on behalf of the patient. Even if they are "anonymous" it makes them just too nervous with all the HIPAA related pitfalls out there. To me the wording is odd for a trained nurse "her heart stopped beating this morning but we got her back up" and "she's honestly not doing good". If the "nurse" is a caregiver maybe. . or if she's contracted as a private duty nurse in the home, it would be OK.

What about informing a lot of people who are interested in a particular patient's progress? Yes, there is a proper way to use the internet, and that is for a family member or friend of the family to do the updates. There are hundreds of blogs set up for exactly that reason, and setting up a blog or Twitter account is very easy and costs nothing. I try not to be cynical in general but this just doesn't feel right to me.

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This has been addressed where I work since we have many young patients who are technology dependent. Those who are family members or authorized direct care givers are given personal updates on medical condition by the the health care professionals just as in any patient situation. What the family chooses to do with that information is their business. At no time are we to post information pertaining to a specific patient, no matter how benign it might be, on Twitter or Facebook. We can post well wishes and information about the latest movies but nothing about patient care just as we couldn't give out information to any stranger who asked "what's wrong with that patient in the hall". Posting to 5000 strangers, in writing, information that you would not normally give out to just anyone is a stretch of most state patient confidentiality practices.

Also, when someone calls a hospital for a general update such as fair, serious and still in ICU, the person must provide the name of the patient. On Twitter and Facebook, you may just have to sign in from some anonymous link and may not know have to know the patient at all but will then have access to this information. One could argue that the media also releases some of the same information but generally that is initiated by the family along with the hospital's public information liaison.

However, I will occasionally surf up one of my former patient's websites to see how they have progressed. But, I am very careful about my comments since I might still be identified as a medical professional by the patient and caregivers or friends.

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Specializes in Nephrology, Cardiology, ER, ICU.

CaringBridge - Free Patient Websites Connect Loved Ones During Serious Health Events.

Legitimate website for pt updates.

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Legitimate website for pt updates.

It is still important to read the privacy information whether you build a website or post to one.

For that site, it has extensive information about collecting personal data and third parties.

http://www.caringbridge.org/privacy

As with any internet site or forum, you are not "anonymous" regardless of what screen name you use. There will be someway to track you. For this reason it is not good to post "anonymously" from your work computer. The website will have your IP location and the hospital can track your computer use.

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Specializes in Nephrology, Cardiology, ER, ICU.

Yes of course. Anywhere on the internet you are never ever anonymous. I just pointed out that Caring Bridge is a well-known site and I've many pts use it to update friends/family and other care providers about their progress.

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Ummmm......NOT a good idea. HIPAA (HIPPA, HIPPO, Whatever....) wouldn't like that, Yogi....

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Has a terminally ill patient ever asked you to post their condition on the internet to keep their friends informed on their behalf? What would you do?

And people wonder why they don't have time to complete the shift?

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Thanks for your perspectives/input!

You're absolutely right- it could be a hoax.

It's definitely an interesting issue as everyone becomes more and more attached to cell phones/Facebook/Twitter.

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