Health Professionals: How Not to Use Social Networks

Increasingly there’s guidance being issued by the various regulators – General Medical Council, Nursing and Midwifery Council etc – on how health and social care professionals should behave on social networking sites. I’m a firm believer that professionals can and should use blogs, Twitter etc in order to facilitate dialogue between the people who work in and use services. I think so long as you follow a certain amount of common sense, it can be done in an ethical and responsible way.

This evening I’ve been watching various paramedics risking their registration by talking on Twitter in a way that could get them fired and hauled up before the Health Professions Council. Here’s a prime example of how not to do social networking.

[Edit: This post originally only blacked out the IDs of non-anonymous tweeters, and included some hyperlinks. After receiving an apology from one of the contributors, I’ve removed all the hyperlinks and blacked out all the Twitter IDs]

This morning, a paramedic tweeted:

There are some NHS workers who use anonymous profiles on Twitter to make Derogatory remarks regarding their patients & treatment. It’s vile.

The paramedic gives an example of the sort of thing he’s talking about.

Love telling patients their saline flush is some magic analgesia, then watching their pain score decrease #Placebo

He then got a series of tweets from other paramedics telling him this is “just venting” and he should “lighten up”. He also got replies like this:

Some of the people replying had profiles giving what I sincerely hope is not their real name. As you can see, those who’ve tweeted non-anonymously have had their IDs and profile pics blacked out – because I’m nice like that.

Well, sorry, but it’s not “just banter”, and the regulators are very clear about that. My own regulator, the Nursing and Midwifery Council, has been increasingly detailed in its guidance on social networking sites.

If you identify yourself as a nurse or midwife on Facebook, you should act responsibly at all times and uphold the reputation of your profession.

I tweeted to suggest that if people want to vent they should do it in private, and pointed out that the GMC, NMC etc are very clear on this. In all fairness to one user he retweeted my comment and asked to see the literature. I sent him the NMC guidance (paramedics are registered with the Health Professions Council, but I suspect the HPC would say the same things). I hope he reads it and takes note of it.

It didn’t take much browsing to discover that the same people were talking elsewhere in ways that could endanger their registrations.

As you can see, with this screenshot I’ve blacked out not only IDs but also the blog link. That link gives the blogger’s name, the city they work in, and the following detail.

We established she had been drinking for 4 hours and had consumed red wine, white wine, beer, shots, shooters and shorts. Standard. We scooped her off the floor and walked / dragged her to the ambulance. She couldn’t walk on her own, her legs were bowing and collapsing under her weight with every step. It resembled the walk of a new born giraffe. We opened the door to the truck and she unceremoniously fell up the steps. She dragged herself to the bed and climbed up. Skirt rolling up to her hips displaying camel-toe for the world to see. It just screamed class.

That’s a summary dismissal and a Fitness to Practice hearing, right there.

Before I was running this blog, I was editor of a group blog called Mental Nurse. At the time when it went down the tubes in March 2011 it was one of the UK’s most popular health blogs. Pandora from Confessions of a Serial Insomniac gave us a lovely obituary, which gives an idea of how it attained that status.

Mental Nurse (MN) had a certain curiosity to it. It was written mainly by…well, by mental nurses (or trainee mental nurses), yet a substantial number of its readers were us lot, the patients. In this way, it was able to bring about a respectful and equal dialogue between these two often disconnected demographics. This was a forum where (in the main!) courteous and empathetic discussion and the swapping of ideas and stories took place, undoubtedly (a) improving the practice and client-understanding of the staff involved and (b) giving us patients a better idea of what goes on behind the closed doors of the offices of CMHTs and psychiatric wards/hospitals, coupled with the knowledge that not all mental health practitioners are ogres

One thing I learned from Mental Nurse was that so long you maintain certain parameters (don’t breach confidentiality, don’t get in touch with your own patients or former patients, don’t slag off co-workers or patients) then social networking can be used by professionals as a force for good.

It really isn’t complicated stuff. Be nice. Be responsible. Show you care about your job. Don’t talk about your patients’ camel-toes.

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11 thoughts on “Health Professionals: How Not to Use Social Networks

  1. Really good and very important post. Even anonymity (although there wasn’t in some of the cases you cited) doesn’t excuse us from professional (and personal) ethical codes. If there’s one thing that gets me angry its hearing other professionals talking about people disrespectfully, there’s banter and there’s cruelty and disregard and there is a difference. I don’t care if that makes me stuffy, I’ll take stuffy because the language we use in private can signify levels of respect or lack of it for those who need the services we provide.

    I am spiteful enough to hope that the person behind that account is hung out to dry. Sometimes I think people imagine Twitter is like an IM client and just don’t realise how open it is..

  2. This is horrendous and I hope that someone somewhere is collating these tweets. The internet is NOT anonymous – ever post can be traced back to the date, hour, minute, second and IP address and MAC address of the device used to enter a comment so a case for immediate dismissal would not be difficult to prepare (same applies to IM clients). Such gossip certainly is not as private as the mess room, A competent employment lawyer could also make a case for dumb ignorance 🙂

  3. Internet anonymity is well overrated. “Anonymous” bloggers and tweeters get found out all the time, either because they slip up or somebody goes digging. When I’m posting I try to keep in mind, “If I went into work tomorrow and my line manager suddenly said, ‘Are you this Zarathustra guy?’ would I be able to defend what I’ve written?”

    Although I’ve blacked out the IDs, I really doubt it would take much for anyone halfway IT literate to trawl back and find out who said what.

    I wonder if any of them are reflecting on this?

    • good practice and something I’ve more or less always adhered to while on the internet for the last 20+ years and tried to explain to others that there is no real privacy on the internet (if you start using serious encryption, bells and whistle will go off in NSA and GCHQ and probably places none know about)

      obviously not: do such people read guidelines about anything?

    • For me, that sums it up – being able to stand by what you say on any blog/tweet/social network etc if it were read by your boss/colleague/service user etc. Anonymity may delude us into thinking we are exempt but it doesn’t and it damages reputation of the profession too.. i know, this makes me sound stuffy but I’ll take stuffy!

  4. Okay, I’ve now received an apology from one of the contributors to the above dialogue. In return, I’ve blacked out all the IDs and removed all hyperlinks.

  5. I decided to reflect for a few days before posting my comment. I agree with some of what you posted and I sent a personal message to the paramedic who first questioned the use of twitter to explain my comments. I did however feel that he took the innocuous comment about the placebo effect completely out of the context in which it was meant. As thus I did suggest, as you posted in your blog, that he should lighten up, and I stand by that. I have read the code of ethics and at work I conduct myself in a professional and courteous manner. On twitter I do grumble about patients but not specific ones. Like with my blog I use poetic licence. I always change age, sex, location of every patient I talk about and I never do it near to the time it happened. The section of my blog that you posted happened to years ago. The blog was inspired by 3 separate jobs and I make it perfectly clear in my bio that what I write about isn’t actually what happened. Its more a work of fiction inspired by reality. I also felt you took my blog paragraph out of context. It doesn’t include the situation we found her in. the treatment she received, nor the abuse and anti social behaviour that occurred towards us. People do need to be careful on twitter and other social networking sights including myself and there are a few things from the links you posted that I didn’t realise and that I will take on board. I apologize if I have caused offence to anyone but I don’t blog to make friends. I simply do it to share the funny side of my job, have some political rants and share the good and the bad times. I certainly don’t believe that any of my blogs or tweets warrant me being ‘hung out to dry’ as one of your readers eluded too. Thank you for bringing some of my failings to light. I hope not to cause offence again.

    Ella Shaw

  6. There is another side to health and social networking, one which intends to connect people suffering from illness and disease, globally, allowing them to discuss there condition and socialize with others who can relate, something that is often missing.

    Its been happening for years in forums, but social networking takes it to the next level.

    See http://www.social-medicine.org, one site breaking through.

    M

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