Speaking of facebook...inappropriate...but am I within my rights...?

Published

Specializes in Gen Surg, Peds, family med, geriatrics.

I'm head nurse at a long term care facility. I have a truly wonderful team and we have a great working relationship. Several of them are friends on facebook.

The other day I noticed one of the facility's residents leaving a message on one of my team member's page. When I checked I noticed that three of my team members were friends with this resident. Some of this resident's comments at work suddenly made sense to me....that's where it came from.

As far as I am concerned, it is most definitely not appropriate for caregivers to have an outside relationship (even on facebook) with a patient or resident under their care. I spoke with the director of the facility and she agreed with me. So I spoke with two of the three and both of them said that they agreed to take the resident as a friend and now they regret it. They don't know how to remove the resident as a friend and explain it. I told them to tell the resident that it's not appropriate and that the head nurse asked them to do so. That's the easy part.

The third team member is my assistant head nurse. She's in when I'm off. She is always chatting with the resident on-line and I seriously doubt she will want to stop.

Now the question here is this: am I within my rights as head nurse to tell her to stop and remove the resident from her list of friends?

Up Vote Up Vote ×

Wow. That is a disaster waiting to happen! Not speaking from nursing experience as much as corporate experience. I wonder if there is a huge case of naivete going on here, or is it more? So many people don't understand the problems that all of the sudden happen with this kind of stuff. Is this person someone you could pull aside and say something to, or not?

What ifs?

Family finding out, questioning motives for ...could motive be $$$? ...or inappropriate relationship? ...or making the resident feel bad about speaking up for self in a case of bad care? ...or even favoritism in care by that RN? ...sign of psyc/soc issues with that RN that might point to other "issues"?

Document, document! any conversations with this RN, do you have good upper management? Are they listeners/rational?

Up Vote Up Vote ×
Specializes in Hospice, Adult Med/Surg.

This may not be a big help, but I worked at a LTC facility once for about a month, and there was a similar situation there. One of the CNAs became romantically involved with a resident, to the point where he was taking LOAs every weekend to go stay with her for a couple of days. The way that facility handled it was that, instead of just firing the CNA, they assigned her to a different hall, so that she was never allowed to care for that patient again. Not a perfect solution, or maybe the correct one, but that's how they handled it. Other than that, yes, I think you have a right to tell those employees to quit the online communication ASAP. What are they thinking? I know what I am thinking: nurse and patient have a personal relationship outside of the workplace = eventual lawsuit. Short of firing them if they don't comply, I guess the above solution, assigning them to a different patient care area, would be the best thing to do.

Up Vote Up Vote ×
Specializes in NICU.

I don't see what's wrong with leaving messages on facebook...

Was she violating HIPAA? Was she treating the patient differently in the LTC facility?

If no, then why the heck does work give a crap about that kind of thing? I think it's pretty overbearing to say that you can't be friends with a patient on facebook if the above two questions are answered no.

Up Vote Up Vote ×
Specializes in trauma, ortho, burns, plastic surgery.

I am so sorry that is happen with you somenthing like that! Look how I will think if I was, you! You could not change people you could change just your self! If you belive that is WRONG, and I belive also, go away from facebook, educate your staff that is inappropiate to have even "virtual" contacts with residents from the same facility. But what you need to know is that "the world" is small, you know me, and I know him, and him know her, and even if you want, you could not control people contacts. What for me and you is inapropiate, for him or her is perfect match ...just because....

So ...go out from facebook and educate your staff....much more is them options.

Up Vote Up Vote ×
Specializes in psych, addictions, hospice, education.

I think you need to ask the other staff person to stop having the resident as a contact on Facebook. You can't control if she does or not, but you have to ask, and then you have to document that you did so. While I know many staff members and residents can develop friendship relationships, it is still unethical to have a personal relationship with a healthcare client. Also, if you are a member of Facebook, the resident has some access to your Facebook information too, depending on how you have privacy settings set up. Contacts of the other staff member can get into the resident's information too, depending on the resident's settings. I'm not sure I would be totally comfortable with that.

I think it's a problem waiting to happen, even if it just becomes a misunderstanding thing. Since you know the friend relationship is there, if you don't do anything about it, you (and the facility as an extension of you) become part of the problem.

If you learn that the other staff member has not stopped being on the contact list of the resident, changing where he or she works is surely an option, but I don't know how much it would help--it might just make the outside of work relationship stronger.

Up Vote Up Vote ×

Another reason why I keep my professional life and personal life separate.

I have ran into a pt I took care of at a social setting and he tried to hit on me and I told him point blank I wasnt interested because it crosses the professional boundaries. Although the care I had given him was clearly over, I can't risk my license and professional reputation by befrinding a pt and if things go south, my license is on the line.

And I also don't have co-workers as my friends on facebook. Facebook is strictly for my personal life and I'm very selective about who is on my friends list since I have pics of my son and family on my fb page. Everyone on my friends list I know personally and have met in real life.

Up Vote Up Vote ×

Its a LARGE can of worms.... The chances of it going smooth are 50% and the chances of it blowing up are 50%. I would say - that if the FACILITY agrees with you to have the conversation - with a WITNESS then go for it (tactfully of coorifice)... Then as others have said document it. That way you butt is covered and the nurse will realize that if anything more comes of it - it could cost her dearly.

As long as your facility is by your side and you are not stepping over the professional line or making threats to fire if she does not delete the resident - than it SHOULD be fine...

But as for the worms - she might resent you... She might gossip about you... She might complain to managers about you and claim that she has the right to her own privacy outside of work, etc.... The facility might throw you under the bus if push came to shove since you are the one who originally had the problem, etc...

Think out your decision and decide which causes MORE PROBLEMS FOR YOU either way.

Good luck - let us know how it goes...

Up Vote Up Vote ×

I don't see whats wrong with it either. Aside from living in fear of someone misunderstanding you and getting offended and the ensuing lawsuits.

It's not just a nurse providing care for a patient you know. When you look past the PC fears, you're also a human being helping another human to get better. I don't think one should sacrifice humanity and connections with others to protect oneself.

I'm still a prenursing student, so admittedly I may be a little naive.

Up Vote Up Vote ×
Specializes in psych, addictions, hospice, education.

To SilentMind...I agree that it can be part of helping another human to have contact that is more friendly than just being the job, but it still is unethical, and seen as unethical, by most facilities. I've worked lots of places. Every single place had rules and consequences against personal contact in the Policies manual, up to and including firing, depending on what the contact was.

As to risking a lawsuit or firing....it's nice to be nice, but I don't have thousands and thousands of dollars to risk to go outside my job description...

Up Vote Up Vote ×
Specializes in ED, ICU, PSYCH, PP, CEN.

My 2 cents on the subject is, if I worked there, and was a friend of said nurse, then resident can see some of my "stuff" and I would not want that. However, once on facebook we have little choice of privacy as we have no idea who our "friends" are friends with.

I keep my facebook friends to a small circle of former co-workers, friends, relatives and former schoolmates.

Only once, a long time ago, did I become friends with a former patient. It worked out okay, but in retrospect I feel it wasn't in the best interest of anyone. We are no longer in touch, and I seriously doubt I will ever promote such a relationship again. There is a reason, based on past "experiences" that the general concensus is "it is not healthy to promote outside relationships with patients" and from now on I am sticking to that.

As for your situation, you need to consult facilities policies and procedures and perhaps risk management in order to know how to proceed

Up Vote Up Vote ×

I am going to start nursing school next year. However, I have been a patient my whole life. I am facebook friends with: 1 anesthisiologist who cared for me during 2 surgeries, my old genetisist who moved away, 1 OR nurse who had cared for me 2 times, my plastic surgeons old assistant who is now in nursing school, same surgeons old nurse.

Up Vote Up Vote ×
+ Join the Discussion