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The blurred line, patients, social media, and safety

HIPAA   (3,925 Views 26 Comments)
by Maggie Ann Maggie Ann (New Member) New Member

-1 Likes; 182 Visitors; 3 Posts

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Social media, it's use, as common as a telephone. Nurses everywhere have cared for a patient that, well, could act inappropriately. After 12 years, I have had my share, remained caring and ethical. I was recently thrown into a very uncomfortable situation and social media was the vehicle. Let me set the table...

A male vascular surgery patient had a successful outcome after a five week stay and was discharged. During treatment he would specifically ask if so and so was working, these were 3 specifuc nursing assistants. He would ask when they were working next, I deferred the question properly, but found it a bit odd, as it happened a handful of times. The patient was discharged after his AKA.

Approximately 3 weeks later, one of these LNAs he consistently inquired about, shows me pictures of our former patient, and she friended him on facebook. She informs me he broke up with his girlfriend, is doing well, and needs rides to get errands done, and her boyfriend will be with her.

I couldn't breathe. I was instantly worried about her safety first, ethics a close second. She is a 19 year old girl, newly licensed. My gut told me this former patient 30 years her senior, had alternate thoughts...

I was an emotional wreck during my days off. I thought I had seen and heard it all, but this...My girl radar was telling me a former patient had my co worker in his sights, and using Facebook as his platform. I anonymously contacted HR, then my nurse manager.

As nurses, patient safety, advocacy, and ethics are the trifecta of this journey we are on, in a million years, I never thought I would have to defend the safety of a co worker from a patient via social media.

See something say something.

Edited by Maggie Ann
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1,131 Likes; 7 Followers; 21,299 Visitors; 2,695 Posts

Your (likely former) coworker knew the rules very well, and was expressly told in orientation not to do what she did. Young coworkers have been raised with technology. These shenanigans are no different than if any of the rest of us had given our phone numbers to patients so they could call us, and then they actually called us.

. She purposely made a bad choice.

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-1 Likes; 182 Visitors; 3 Posts

While young health care providers have grown up in the age of instant information, this does not discount the possibility of their caring nature, coupled with naivete, to be at risk. Recent reports by the joint commission show a spike in healthcare workers being stalked or harrased by former patients.

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psu_213 has 6 years experience.

26 Likes; 27,412 Visitors; 3,869 Posts

While young health care providers have grown up in the age of instant information, this does not discount the possibility of their caring nature, coupled with naivete, to be at risk. Recent reports by the joint commission show a spike in healthcare workers being stalked or harrased by former patients.

This LNA (not sure what that is) is an adult, she has the right to make bad choices. I do agree that this sounds potentially unsafe; counsel her about it. Other than that, you don't really have any other obligations, nor is there much more you can do to change the free will choice of a competent adult.

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-1 Likes; 182 Visitors; 3 Posts

The responses here are alarming. HR refesher courses are needed. Code of Conduct ring a bell?? No one has a right to make bad choices

Our licensure expectations of behavior do not stop when we punch in or out, including social media.

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psu_213 has 6 years experience.

26 Likes; 27,412 Visitors; 3,869 Posts

No one has a right to make bad choices

Are you in the US? Serious question, because barring a very few conditions (suicidal/homicidal ideation being the most obvious), an adult very much has the right to make bad/dangerous/self destructive choices. You can notify HR and they can disciple the employee for violating social media policies, but no one can prevent her from making contact with this former pt.

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As a patient this is one of the things that concerns. I have seen nurses with personal cell phones on the floor that could lead to possible pictures, statements etc being posted about their day to day life in the hospital or nursing home that would or could possibly a violation. How are the patients assured that someone is not snapping pics and keeping on their personal cell phone? When you have people in a vulnerable situation they should be safe but in today's society is seems to be let's just post it! But that is off topic of this post.

This young woman is an adult and should have just known better than to get involved in a patient's personal life. Giving suggestions on how to get help as far getting to doctors, picking up groceries or whatever the patient may need is one thing but to personally get involved with actually a complete stranger even though you may have cared for he/she in a professional setting is asking for a bad outcome. This young lady may have cared for this patient doing such things as personal care, even just being polite and helping him out and if he tracked her down to make personal contact with her that is scary. As all people who work in a field where you have constant contact with the public, even nurses and doctors have to be careful. The thing is you have to keep in mind at all times that your information is out there and you can be found just by a simple search.

I have heard so many times from healthcare givers we see this all day and it doesn't mean anything to us to the patient it can mean something entirely different. Even just being friendly can be misconstrued as flirtation. While patient safety should be upmost in everyone's minds so should the safety of the nurses/staff/physicians for a patient to contact a caregiver other than to ask for professional advice is suspect.

You did the right thing in reporting this to someone. I suspect your radar is right. It is so easy to be led down the wrong path when you are only trying to help a fellow person in need or that you perceive are in need. I would venture to guess that your place of employment have rules about making contact with former patients and becoming involved in their personal lives and this could have been a disaster waiting to happen.

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Have Nurse has 25 years experience and works as a A.D.O.N..

5 Likes; 15 Articles; 7,673 Visitors; 713 Posts

Your (likely former) coworker knew the rules very well, and was expressly told in orientation not to do what she did. Young coworkers have been raised with technology. These shenanigans are no different than if any of the rest of us had given our phone numbers to patients so they could call us, and then they actually called us.

. She purposely made a bad choice.

I agree. Boundaries: Why is this such a foreign concept????

Bad ethics. Her conduct is reportable.

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Have Nurse has 25 years experience and works as a A.D.O.N..

5 Likes; 15 Articles; 7,673 Visitors; 713 Posts

This LNA (not sure what that is) is an adult, she has the right to make bad choices. I do agree that this sounds potentially unsafe; counsel her about it. Other than that, you don't really have any other obligations, nor is there much more you can do to change the free will choice of a competent adult.

I must respectfully disagree with this. Ethics and Boundaries are taught as part of our requirement for holding a license. She has an obligation to use good judgment and protect her license. You don't stop being a nurse when you go home at the end of the day.

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OyWithThePoodles has 10 years experience as a RN and works as a Registered Nurse.

241 Likes; 1 Follower; 11,470 Visitors; 1,211 Posts

As a patient this is one of the things that concerns. I have seen nurses with personal cell phones on the floor that could lead to possible pictures, statements etc being posted about their day to day life in the hospital or nursing home that would or could possibly a violation. How are the patients assured that someone is not snapping pics and keeping on their personal cell phone? When you have people in a vulnerable situation they should be safe but in today's society is seems to be let's just post it! But that is off topic of this post.

This young woman is an adult and should have just known better than to get involved in a patient's personal life. Giving suggestions on how to get help as far getting to doctors, picking up groceries or whatever the patient may need is one thing but to personally get involved with actually a complete stranger even though you may have cared for he/she in a professional setting is asking for a bad outcome. This young lady may have cared for this patient doing such things as personal care, even just being polite and helping him out and if he tracked her down to make personal contact with her that is scary. As all people who work in a field where you have constant contact with the public, even nurses and doctors have to be careful. The thing is you have to keep in mind at all times that your information is out there and you can be found just by a simple search.

I have heard so many times from healthcare givers we see this all day and it doesn't mean anything to us to the patient it can mean something entirely different. Even just being friendly can be misconstrued as flirtation. While patient safety should be upmost in everyone's minds so should the safety of the nurses/staff/physicians for a patient to contact a caregiver other than to ask for professional advice is suspect.

You did the right thing in reporting this to someone. I suspect your radar is right. It is so easy to be led down the wrong path when you are only trying to help a fellow person in need or that you perceive are in need. I would venture to guess that your place of employment have rules about making contact with former patients and becoming involved in their personal lives and this could have been a disaster waiting to happen.

With all due respect, some of those "personal cellphones" may have actually been work phones. Our charge nurse phone is an iphone. :)

I must respectfully disagree with this. Ethics and Boundaries are taught as part of our requirement for holding a license. She has an obligation to use good judgment and protect her license. You don't stop being a nurse when you go home at the end of the day.

I believe this person is a nursing assistant, that being said, she made the decision to friend this guy and then agree to drive him places. That's crazy to me. But ultimately her decision. She isn't harming herself or other patients, doing anything dangerous (stupid maybe) so while it isn't something she should be doing, she made that decision.

I know many L&D nurses who friend mom's on facebook and come to be lifelong friends.

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227 Likes; 1 Follower; 44,084 Visitors; 2,941 Posts

MRI studies show the human brain may not be fully developed until the age of 25.

I appreciate Maggie Ann being concerned about this 19 year old LNA.

I wish a concerned adult would have befriended and counselled me about the stupid decisions I made between 16 and 25.

Edited by brownbook

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psu_213 has 6 years experience.

26 Likes; 27,412 Visitors; 3,869 Posts

I must respectfully disagree with this. Ethics and Boundaries are taught as part of our requirement for holding a license. She has an obligation to use good judgment and protect her license. You don't stop being a nurse when you go home at the end of the day.

I'm a little confused about who needs to protect their license.

The nursing assistant can be reported to HR for violating boundaries (i.e., contacting a former pt on Facebook). Perhaps HR can "go after her" for agreeing to meet the former patient in question. However, there is nothing that can be done to prevent the NA from making the bad decision of risking her safety by giving the former patient a ride.

If you are referring to the OP--she can report to HR the boundary issue and counsel the NA about how dangerous her actions could be, but I can't see anything else that she needs to do to protect her license obligates. Park the NA in so she can't go pick up this former patient? Call the police and tell them that this NA might be putting herself in danger? I really don't see what else the nurse is supposed to do, although I am certainly interested to hear what other people think.

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