Nurses, Hospitals, and Social Media: It Depends What Business You’re In

Zuckerberg/via Flickr, World Economic Forum

Before the placenta picture posted on Facebook by a nursing student made national news, I read Time Magazine’s “Person of the Year 2010,” by Lev Grossman. Born in 1984, Mark Zuckerberg, the inventor of Facebook, is decades younger than the average working nurse. According to the article, so many people now belong to Facebook that if the Web site were a country “it would be the third largest, behind only China and India.” To refuse to recognize the social impact of Facebook is to miss the boat.

Throughout the nurse blogosphere, nurses are demanding that hospitals create policies about the use of social media. Some hospitals have. Not surprisingly, these documents state that no unauthorized photographs of staff, patients, or patient care areas should be taken, let alone posted on the Internet.

Hospitals with social media policies are not necessarily squelching their employees’ right to freedom of speech. They don’t want to spend time and money in court defending their public image. They already spend lots of money on marketing. They are in the business of patient care, not entertainment. So hospitals with social media polices take the position that you can post or tweet to your heart’s content, but should keep in mind the following:

• Nothing you post is private.
• If your online behavior disrupts patient care or creates hospital liability, the hospital reserves the right to fire you.

Consider your personal commitment to your own rights. Do you really want to catch every ball that’s thrown to you? Hospitals don’t want to spend their time and money on social media lawsuits. Do you?

Social media is not going away. One of Mark Zuckerberg’s profitable insights is that people like reading about and seeing their friends and friends of friends online. A few years ago, many of us were upset when the Patriot Act made it possible to force libraries and bookstores to report which books their patrons read. Now we want everyone to know what books we “like,” and no one seems to mind that Amazon tracks what we read, then focuses ads according to our purchases.

My own concept of privacy is changing. I have an affinity for privacy. I wonder if this is a product of my generation, a sign of not keeping up? Are my interests and ideas really too sacred for public information? “If you have something that you don’t want anyone to know, maybe you shouldn’t be doing it in the first place,” challenges Zuckerberg. However, it’s not only whether what I’m doing is right or wrong. It’s also about my right to choose with whom, when, and how I share my information. Privacy grants protection.

One of the many important reasons for HIPAA privacy regulations is to keep peoples’ health care status private, thus protecting them against dismissal from a job—or rescinding of health insurance coverage—by employers who don’t want the cost or potential inconveniences of having sick employees. Once last year’s much-debated Patient Protection and Affordable Care Act goes into full effect, it will be more difficult for employers to fire employees based on their health care needs, and such safeguards as the consent forms that patients fill out on admission granting limited third party access to their health records may become unnecessary—but I doubt it. Many people prefer to keep their conditions private, and it is my job as a patient advocate to protect this right.

What constitutes personal privacy will always vary between individuals. It took years to realize that everyone doesn’t understand ideas the same way I do, and it’s taken longer to learn to not suck all of the oxygen out of a room when making a point, leaving room for the opinion of others. As an artist and a writer using social media, I hope that society continues to relax its ideas about privacy, because I think there is a lot to gain through sharing ideas and stories. Regardless, I am a nurse, and when I practice nursing, my priority is patient care, not entertainment.

Julianna Paradisi blogs at JParadisi RN; her artwork appeared on the cover of the October 2009 issue of AJN, and her essay, “The Wisdom of Nursery Rhymes,” is upcoming in the February issue.