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

[laurasc]

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?

[elkpark]

TXP, It wasn't meant to be so cold. As nurses it is simply your right to privacy we are bound to uphold. Silly hypothetical: say you just had another surgery in your quest to change sexes. You and I shared many laughs during your hospital stay and we bonded. I see you in Target and happily approach you and ask, how are you doing? We chat it up. You are there with a friend from work on your lunch break, who, I know because we see each other at a spin class at the club. She knows I work for a certain type of surgeon and knows you took time off for some surgery two weeks ago...even though our conversation never went there...

A very silly scenario, but actually privacy violations far simpler often cause unforseen tragic consequences, be it for the patient or for the nurse. You see, my job might be at stake.

You may consider your scenario "silly," but similar situations do occur -- I started my career working on an inpatient psychiatric unit in a community hospital in a rural area where most everyone knew most everyone else's business. It was common knowledge that I worked on the psychiatric unit (as an outsider recently moved to the area, I sort of "stuck out"), and I was v. cautious about greeting former clients in the supermarket, convenience store, etc., because it would be easy and reasonable for people to assume that the reason I knew someone was because they had been hospitalized on the psych unit, and I didn't feel it was my place to "out" them if that wasn't already known.

[txpt06]

TXP, It wasn't meant to be so cold. As nurses it is simply your right to privacy we are bound to uphold. Silly hypothetical: say you just had another surgery in your quest to change sexes. You and I shared many laughs during your hospital stay and we bonded. I see you in Target and happily approach you and ask, how are you doing? We chat it up. You are there with a friend from work on your lunch break, who, I know because we see each other at a spin class at the club. She knows I work for a certain type of surgeon and knows you took time off for some surgery two weeks ago...even though our conversation never went there...

A very silly scenario, but actually privacy violations far simpler often cause unforseen tragic consequences, be it for the patient or for the nurse. You see, my job might be at stake.

Real scenario:

I teach a Continuing Education Class. This past semester one of my students was a Psych Nurse at a local hospital. Two weeks after the class ended we saw each other outside in a perking lot of a local store. During the summer I was hospitalized. It could look to a casual observer that I was hospitalized for psych reasons rather than the pneumonia that I was really in for. A conversation between two acquaintances does not necessarily denote anything. Unless, of course, one of the two says something that indicates where the relationship started.

My point is this: Any two people who are acquaintances are just that,acquaintances. Only they know how they know each other.

As a patient, I would find it very strange to see someone that I knew, who might have gotten me through a very trying time in my life, who would not talk to me outside of the hospital. I understand that you see a potential for a HIPPA violation. Unless, the conversation falls to my condition, I don't.

[dianajh73]

I recently ran into this issue when I had to point out to a classmate that she was posting questionable statements on FB and may not realize that some of our nursing instructors have access to those.

Some people may not quite understand how FB works, but if, for instance, I have friend A who has friended instructor B. If my friend A makes an update and I comment on it, then instructor B can see it. In my classmates instance she added a comment to Friend A's post - "heading out to psych clinical to work with crazies - oooh fun." (or something to that effect). EVERYONE on BOTH my classmates AND friend A's friends list can see that. It sounds like this is how the OP found out about the patient being "friends" with the staff.

I love FB because it lets me know what is happening with people I don't have time to talk to individually (cousins and acquaintenances etc...). It is just networking, but you do need to be aware of who you have friended and know that ANYTHING you write can get out to ANYONE!! So always write like your boss, friend, SO, and kids are all going to read it because having private settings doesn't mean that others won't see it because of "friend of friend" type issues.

[elkpark]

Real scenario:

I teach a Continuing Education Class. This past semester one of my students was a Psych Nurse at a local hospital. Two weeks after the class ended we saw each other outside in a perking lot of a local store. During the summer I was hospitalized. It could look to a casual observer that I was hospitalized for psych reasons rather than the pneumonia that I was really in for. A conversation between two acquaintances does not necessarily denote anything. Unless, of course, one of the two says something that indicates where the relationship started.

My point is this: Any two people who are acquaintances are just that,acquaintances. Only they know how they know each other.

As a patient, I would find it very strange to see someone that I knew, who might have gotten me through a very trying time in my life, who would not talk to me outside of the hospital. I understand that you see a potential for a HIPPA violation. Unless, the conversation falls to my condition, I don't.

You may feel this way, but not everyone shares your views and it's our responsibility, as professionals with access to private information about people, to err on the side of caution.

[netglow, ASN, RN]

Txp,

I cannot think of any more examples. Know that as nurses we are bound legally by our license to practice a certain way. Work is work. I think it is important to say that nurses don't look at patients as a source for personal relationships... at all. Telling you the facts Jack :wink2:, sorry, but that's the deal.