Should We Be "Facebook Friends?"

I wanted to touch on the article Misuse of Social Networking May Have Ethical Implications for Nurses by Deborah McBride and Eric Cohen in the latest edition of ONS Connect. I remember when Facebook first started out many years ago. I was a sophomore in college at UT Knoxville and I thought the whole concept was quite ridiculous. What was the point to be Facebook friends? Well, then I joined and became addicted to "Facebooking," much like the rest of my friends. After all, you were not officially in a relationship until it was confirmed on Facebook. Now, years later Facebook is among one of the top social networking avenues for people of all ages to stay connected.

The problem with Facebook and probably many other social utilities is that people disclose way too much information about themselves to sometimes unintended audiences. Another problem is that patients are asking nurses and other health care professional to "be friends" on Facebook. I have dealt with this situation first hand and it canbecome very akward if you do not take a stand on this matter and be consistent. A sweet little 8 year leukemia patient befriended me on Facebook. At first I thought, how sweet, she wants to be my friend. But after analyzing the situation, I thought that I did not want patients and their families knowingwhat I am doing or who I am talking to outside of the work environment. If anything, it felt like a lack of privacy. I think it would have been incredibly inappropriate to be friends with patients or family members on Facebook.

Another problem I have seen with the users of Facebook is that so many people use the status update feature of facebook to vent about their boss or work in general. This is completely inappropriate and can cause major problems if certain people, like your boss see this information. I think the main point I have is to be professional. Remember that our personal lives and professional lives should always remain respectful. Facebook is not the place to vent about work or the patients you care for. Facebook is meant to be a social utility to connect people.

What are your thoughts about social networks like Facebook and Twitter? Are you "facebook friends" with your patients?

Comments

[Joni Watson]

I echo many of your statements. I am a big fan of social media, believe me. It has so many useful purposes. Just like money and buildings, though, social media is neither inherently good or bad. It's a thing. We, people, make it good or bad. I use several social networks for very different reasons. Facebook is more personal and Twitter is more professional, at least for me. There are absolutely people I do not befriend on Facebook for the very reasons you mentioned and beyond. For example, I am not FB friends with anyone from organizations that my organization currently has a grant with. I likely won't ever be friends with them because I likely will apply for future grants, and I want to avoid even the appearance of conflict or bias. I am a manager, and am friends with all of my staff. I am more conscious about what I post, and you're right - all of our communication should be respectful. I use Twitter in a more professional avenue, and I have found it very beneficial. I do follow some nurses and physicians and have even unfollowed several because of their tweet history.

[Eric Cohen]

Joni and Kari, all excellent points that you make. Yet I see it happening in institutions all over... patients and nurses friending each other. Would love to hear from those nurses too... let me play devil's advocate for a second... are nurses getting support from their patients on facebook? Is this a way for nurses to see what a good job they did with their patients?

[Joni Watson]

Interesting question, Eric. I'm not sure I can answer it because I no longer work in the clinic setting and personally don't have any FB patient-friends. I am sure that could be true - nurses receiving some sort of continuous validation via social networking - which is unprofessional and unhealthy in my opinion. However, it could also be simply an awkward moment that nurses aren't sure how to handle professionally (thus the great need for all the education via ONS Connect and other nursing publications). Maybe nurses get a request, just like Kari did, and think it might be awkward to confront that patient the next time - knowing that the patient knows the friend request was ingnored? I'm simply speculating based on what I might feel if this happened to me. As oncology nurses, we see our patients frequently, get to know the details of their lives, meet their children or parents, etc. so many nurses may feel social networks are extensions of that without fully understand the implications. More (and continuous) education on the protection of the professional role of nursing while using social media is definitely needed.

[Andy Guinigundo]

Great conversation!

What Joni says is true - if you are looking to FB for validation then you've got other issues! Most definitely, nursing validation, that "pat on the back", (or perhaps the lack thereof), is a huge issue for nursing. I do not believe that social networking is the answer.

You almost have to apply that familiar email etiquette tip to social networking: don't put something in an email that you wouldn't say to someone's face. The title "social" networking is problematic from the get-go from a patient-nurse relationship standpoint. I am not saying do not be human or social to patients in an appropriate setting. But, would you ask a patient to go out to dinner and a movie? Would you invite them to you child's birthday party? Those would seem like awkward situations to say the least. So why should an online social situation be treated any differently?

There are many more uncomfortable situations that arise in a clinic than me "ignoring" someone's friend request. A good nurse has to think on her feet and make that situation right. For example, I think it would be extremely uncomfortable if a patient tried to personally give me money. The professional reaction would be to refuse that despite what that might do to that particular patient-nurse relationship.

Social networking is a VERY powerful and useful tool. In this case, let's treat it like a chainsaw, i.e. very powerful and useful, but a dangerous tool if used incorrectly.

[Laura Phillips]

I don't twitter or tweet or Facebook or any other of these venues of communication. My personal and professional lives are nearly totally separate. This allows me to truly be a friend to my friends, and truly be the nurse my patients need me to be. I certainly agree with Andy: social networking is powerful. Network with your collegues, be friends with your friends in a manner that works well for you. But be a nurse, the very best one you can be, and keep the professional boundry tight and sharp. You can be compassionate and friendly without being "friends".