Two weeks ago I attended the Australian Nursing and Midwifery Federation (Vic. branch)’s annual delegtes conference for job representatives – it’s an opportunity to learn, network, strategise, and propose the resolutions which form the basis for our log of claims at every Enterprise Bargaining Agreement negotiation.

This year one of the most interesting presentations, in a highly competitive field, was about the use of social media by health care staff, and the presentation caused me to reflect on the growing presence of soocial media, and what that may mean for us.

Certainly the ANF’s  Facebook page was a significant component of our success in the 2011/12 campaign, in terms of connectedness, morale and communication – as discussed in this interesting article in Business Spectator. There is, however, a lot of concern about health professionals – particularly nurses and midwives – using social media. There’s no question that, both in our profession and across other industries, people have lost jobs, careers, reputations and relationships over ill-considered social media use.

In consequence, there are some who advise nurses and midwives to avoid social media use altogether – or to use pseudonyms. Quite clearly that’s not my position – Iuse my own name here and on Twitter, and though I don’t advertise my workplace, it’s easily found on a Google search.

I believe that social media is increasingly a part of our lives – from the prominent platforms, like Facebook, to applications you may not think of as social media, like Pinterest, blogs, websites like AllNurses, and even comments on digital articles. We need to embrace and utilise it, not fear and avoid it.

Nursing and midwifery are professions that encompass an enormous variety of populations – some, like myself, utilise multiple social media platforms, while others check email once a week and that’s it. Most of us, though, fall somewhere in the middle – perhaps a Facebook account and a LinkedIn profile, for example.

Social media can be a valuable tool – Facebook and MySpace help maintain relationships with friends and former colleagues; Twitter is a great source of news and activism; LinkedIn can help you develop a professional network and generate job offers; Academia does the same thing for higher degree students and academics; blogs allow you to share your opinions, often with like-minded people; while YouTube, Pinterest, Tumblr and Vimeo can be valuable sources of information, but also eat vast chunks of time!

However, an increasing number of employees, including health professionals, are finding themselves in disciplinary action over inappropriate use of social media. These range from derogatory remarks about a supervisor, to action that could lead to deregistration, including inappropriate relationships with patients and breaches of confidentiality.

The first thing is to check your privacy settings – who has access to your posts or data? On Facebook you can check what a stranger, or any specific friend can see – if you click on the padlock icon, then “who can see my stuff?” the option View As comes up. This shows you what your page looks like to someone you haven’t friended.

However strong your privacy settings are (and with Facebook they’re frequently reset, often without notice), anyone you’re friends with can take a screenshot of your page. Or, as I was reminded while I was typing this, by sharing your post – I don’t swear on publicly-accessible social media but I do on my own Facebook page, and fifteen minutes ago a friend reposted something I’d written that was more sweary than I’d like out in the general domain.

However, I don’t ever write anything that I wouldn’t be okay with being made public. I’ve certainly written things in private messages that would be personally embarassing if they were made public – but nothing that would embarass my employer, any organisation with which I was affiliated (like my university or my union), or anything that breaches my duty of confidentiality. Because even if you delete a post, nothing’s really gone once it’s sent out into the world.

I try to live my life with integrity, and I firmly believe that my online interactions shouldn’t be separate from that – social media is a part of my life, not an entity separate from it. It seems to me this is rarely the way social media is viewed, however – particularly when organisations draft policy.

Nurses and midwives have at least two policies that their social media use may be held up against – their employer’s, and the Australian Health Practitioner Regulation Agency’s. The former tends to deal with patient and organisational confidentiality; the latter is significantly restrictive, has been broadly criticised, and is back in review – I found the most useful discussions about AHPRA’s draft policy were by Ian Miller at ImpactedNurse, and Melissa Sweet on Croakey (the health sub-section of Crikey). In addition, I strongly recommend reading the ANMF Vic. Branch’s advice.

What safe social media use boils down to, though, is using common sense: don’t do anything online that is unprofessional or that you would be embarrassed to have made public.

On the most obvious front that includes measures to safeguard the public – don’t post photos from work that show you acting unprofessionally; don’t post identifiable information about a patient, staff member or family member (this is particularly a problem in rural workplaces, but is an issue across the board – and wherever you work, even if you don’t identify your workplace in that post, it may be clear from other posts, or your profile); don’t post photos of patients.

The second layer of caution concerns how you portray your own professionalism: don’t post if you’re on sick leave; be cautious about posts that, though not at work, may lead to speculation about your reliability – tht reference recreational drug use, for example. Be aware that posting a status about how drunk you are at 2AM may be a problem if your make an error during a morning shift six hours later. And recognise that employers increasingly Google potential staff, often prior to interview. Try putting your name into a search engine – you may be surprised by what comes up!

Finally, remember that digital photos contain metadata – when the photo was taken and, with newer technology, where. This has caused disciplinary issues for staff who’ve called in sick for work, then posted photographs of themselves during that time – even if the post was made some time afterward.

All of that can make it sound as though nurses and midwives really should avoid social media! But it boils down, as I said, to using common sense – if you’re not sure whether or not to post something, wait.

Here’s what I’ve gained, after only using social media as a tool for about eighteen months:

  • I became heavily involved in the ANF (Vic. branch)’s EBA campaign, which has made me recognisable to nurses across the state
  • as a result of my interactions on the Respect Our Work page I developed a reputation for dispassion, advice and reliable information
  • posts on that page formed the foundation for this blog, which is now being archived by the National Library
  • I became known to staff and officials of the ANF, which contributed to being selected for the Anna Stewart Memorial Project at Trades Hall
  • that program, combined with union activism on Facebook, Twitter and at events has resulted in a soicial media role with VTHC for a project next year
  • I was asked to represent ANF when our NSW colleagues launched their EBA campaign earlier this year
  • I was voted, along with 21 other delegates, to represent Victoria at the ANMF bi-annual Federal conference later this yearÍ’m running for ANF (Vic.) branch council
  • one of the people I met through Twitter has asked me to give clinical advice of a patient dependency modelling system he’s co-developing for interstate application
  • I’ve been nominated for a social media award
  • I have over 1500 followers on Twitter
  • I’ve had five tweets broadcast during the program Q and A
  • I’ve been able to disseminate petitions, questions and information to a far wider audience than I could ever otherwise reach
  • I know people across professions, industries and around the world I’ve never have otherwise been in touch with – like a plenary speaker fromt he UK coming out for a conference later this year
  • I’ve met people who have already changed my life…

and at the beginning I wasn’t even aware that’s what I was doing!

Social media is a valuable tool that can enhance both your personal and professional lives.It can allow you seek, and share information at an amazing pace; it can allow you to become informed about issues you knew little about; it can connect you with like-minded people, and intriduce you to ways of thinking wholly alien to your own.

But it is a double-edged sword that should be used with caution. Remember than nothing is really private, and no account is really anonymous. If you wouldn’t say something publicly, you shouldn’t broadcast it electronically – and you can be in both professional and legal trouble for things you publish or re-publish electronically, including libellous or defamatory statements.

Provided you can keep those caveats in mind, social media has the capacity to enhance your life – while siphoning awy hours of it!
I am indebted to fellow nurses and enthusiastic supporters of social media Paul McNamara (whose recently wrote on nursing and social media), and Damien Hurrell for a brief but useful exchange earlier today – the hypertext links go through to their Twitter accounts, if you’re looking for great people to follow.