Prposal essay

Teaching and Learning in Nursing (2014) 9, 144–147

EDUCATE, EXCITE, ENGAGE

www.jtln.org

Tim J. Bristol PhD, CNE, ANEF*

Social media policie

⁎ Corresponding autho E-mail address: tim@n

http://dx.doi.org/10.1016/j. 1557-3087/© 2014 Nation

s for success

Sammy is a new registered nurse (RN) on the medical surgical unit. She graduated 4 months ago and just passed her NCLEX 3 weeks ago. She is excited to be on the unit for her first full shift. She met her preceptor and is going to meet the client. A quiet older gentleman (Mr. H.) who smiles and seems interested in the fact that Sammy is a new nurse. After a few hours into her shift, she enters the patient’s room. She leans over the client and takes a “selfie” with Mr. H. After showing it to the client, he smiles. That night she proudly posts the photo as her new profile picture. Three days later, Sammy is in the human resources department with her nurse manager facing disciplinary action to include termination. She finds out the family is outraged and want actions taken against “that nurse.” The family notified the state board of nursing.

Unfortunately, Sammy was a high-achieving student. Unfortunately, as a student, she never learned how to professionally manage social media. Unfortunately, this scenario is not uncommon (National Council of State Boards of Nursing [NCSBN], 2011; Peck, 2014). A quick Internet search will reveal many such stories of well-meaning nurses excited about their clients and their profession.

What are we doing to prepare our graduates to be professionals in the 21st century? One might say that we live in the age of social networking. Nursing programs need to find ways of helping train future health care professionals in using these tools to improve patient outcomes. Policy will help promote success in this journey.

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1. Usage of social media in health care

Reviewing a couple hospital and health care system Web sites quickly reveals how social media is being used to connect with current and potential clients. One estimate is that more than 1290 hospitals are using Facebook (Mayo Clinic, 2012). Some facilities are now using wearable technology and social networking such as Google Glass to connect health care providers and share data (Glauser, 2013; see Fig. 1). For the student, nurse and faculty member, the message is that social media is a positive tool for use in the health care industry. The conflict arises when the nurse tries to cross the chasm of professional and personal life.

Fig. 1 Paula Byrne, MSN, RN, from the College of St. Scholastica is a Google Glass Explorer.

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Clear policies, that are communicated well, will help students, faculty, and nurses make decisions that allow for successful use of social media in nursing education.

2. The policy development and dissemination process

An effective social media policy is best developed by a diverse team at the college or university level. The team will work with multiple stakeholders to ensure that it promotes professional growth while helping faculty and students adhere to essential regulations. Once the policy is developed, dissemination must be managed and frequently evaluated. A variety of strategies can be used to ensure successful implementation.

2.1. College wide collaboration for policy development

Ideally, the policy on social media usage will originate at the college or university level. Partnering with other depart- ments will help faculty and students across the campus with a consistent message of acceptable “virtual” behavior. An interdisciplinary committee will benefit from rich discussions and collaboration around theuse of social media.This promotes better understanding of the opportunities and challenges faculty and students face when using these resources and tools.

2.2. Departmental team and student involvement

Even with a college-wide approach, social media used in health care settings presents unique challenges. Because of the need for patient privacy, social media policies for the nursing program will need to consider the tenets and regulations found in the Health Insurance Portability and Accountability Act (HIPAA; NCSBN, 2011). It is essential that faculty and students fully understand the regulations related to maintaining privacy for the client.

Asking students to participate in the policy development will help ensure adequate explanations, and expectations are included. The students often view social media with different perspectives as compared to faculty. Faculty also have the potential to learn of creative uses of technology when collaborating with students in this way.

At the departmental level, once an initial policy is drafted, the entire faculty should offer suggestions for revisions.

2.3. Clinical agency involvement

The importance of involving clinical agencies in social media policy development cannot be understated. They can offer valuable insight to ensure the policy will facilitate success for students and faculty in the clinical agencies. This action will also help build trust between the clinical agency

e nursing department. Trust facilitates capitalizing on ocial media benefits for both patients and students. Often, linical agencies will begin to see the nursing department as a esource in the process of managing social media.

. Policy components

The different components of the social media policy can ary depending on the intended audience and location. Some olicies may be global in nature and address the student in ultiple environments (see Appendix A). Other policies are ore specific and directed to only the clinical environment (see ppendix B). Identifying the purpose of the policy will help ith in selecting components and concerns to be addressed.

.1. Professional components

The main reason most schools and programs develop and nforce a social media policy is to avoid violations of HIPAA. eing clear on the sharing of protected information is essential. t is also useful to give clear guidelines with devices and on- ne services. For instance, a direct statement related to not king photographs of clients is appropriate. Another directive hould involve common social networking tools such as acebook, Twitter, and email. No information regarding the linical experience should be shared using these tools. Lewis nd Clark Community College went on to include “and any thers not mentioned.” The reason for this phrase is that chnology evolves quickly, and a new tool may become vailable before the policy can be adjusted. This part of the policy will also emphasize that the student is

esponsible to strictly obey any guidelines or policies of the gencies in which they are active as a student or professional. tudents should remember that even when they are not at chool or the clinical agency, they can still violate federal andates related to HIPAA and disciplinary action may result. Some policies give guidance on professional etiquette. ppendix A explains the importance of acknowledging the lient when using mobile technology in their presence. It also mphasizes that when using mobile devices in clinical, staff nd faculty have the right to view the student’s phone.

.2. Academic components

Faculty and students must understand certain academic rinciples as well. For instance, Appendix A states that e “nursing program” can take disciplinary action based n what happens on-line. Students can only take pictures labs when it is part of an assignment. Students may not

se their phones for personal conversations or texting uring “class, lab, and clinical experiences.” This policy oes as far as to remind students that what happens on- ne could be viewed by potential employers. In addition, aculty must be aware that they cannot violate student rivacy on-line.

146 T.J. Bristol

4. Policy distribution

Once the policy has been developed, administrators and faculty should decide on a strategy for distribution. Most schools find it ideal to put the social media policy in the nursing student handbook, as well as a reminder in the syllabi. Gateway Community College in Phoenix, Arizona, has chosen this strategy (see Appendix A). The repetition serves as a means of ensuring students (and faculty) understand and abide by the policy.

Other schools choose to address it in more of a formal agreement or contract that requires a student signature. Lewis and Clark Community College does just that (see Appendix B). By signing, the students become aware of the importance of the policy.

Consistent implementation of distribution practices will help students and faculty remain cognizant of the important concepts found in these policies. Consistent enforcement of the policies is also essential. Any faculty or student with a question related to their school or program policy on social media should quickly seek the advice of an administrator. Being clear on how to use social media as a professional will help avoid disappoint- ing consequences while promoting best practices in health care-related informatics.

Appendix A. Maricopa Nursing – Handbook

Criteria for use of MOBILE DEVICES/SOCIAL NETWORKING during Clinical and Classroom Rotations

Mobile devices can be a valuable tool for health care education when used appropriately. The following guide- lines apply:

• Professional behavior and proper technology etiquette should be observed at all times when using cell phones, iPads, iPods, mobile devices, laptops or other electron- ic devices.

• These may be used only when authorized by faculty and for clinical activities, not personal use.

• Cell phones and all mobile devices must be on “silent” mode or turned off during class, lab, and clinical experiences.

• No photos may be taken by students in the clinical agency or lab environments. The exception to taking photos or videos in the laboratory environment is when it is a course assignment.

• No personal phone conversations or texting allowed at any time while in lab, class, or clinical. A clinical probation will be given for the first violation of using the mobile device for socializing during clinical time. A second violation may result in course failure.

• For combined cell phone/mobile device appliances, students are expected to have the equipment turned off if agency policy requires it and go to an area designated for cell phone use when accessing information on their mobile device.

• Be respectful to the client at all times and ensure that your entire attention is focused on the client when you are in the client’s room. If you are using any type of mobile device at the bedside be sure to apologize for the interruption in care and explain how this will help in their care.

• Faculty or hospital staff may ask to see what programs you are using at any time. Use of facility computers for personal use is prohibited.

• You must protect the confidentiality of patient information at all times in accordance with HIPAA. Students may not take any photographs of clients or client records, nor make Xerox copies of client records.

• Students who violate patient privacy with the mobile device will be subject to HIPAA infractions of the clinical agency and may be subject to disciplinary action.

• Just as other medical equipment may act as a reservoir for microorganisms and contribute to the transfer of pathogens, so may mobile devices. Be sure to disinfect/ decontaminate them as needed.

• Social networking sites: When contributing to a social networking site, it is important to remember that everyone can see and read what is placed on the site even if “privacy” options are selected. Keep your interactions professional and err on the conservative side when placing written communication or posting pictures. Always remember that your on-line pres- ence reflects you as a professional. Be aware that your actions captured via images, posts, or comments can reflect on you and many recruiters now routinely search the social networking venues when consider- ing people for a new hire. It is never appropriate to post photos or information about a patient. Social network postings can be subject to disciplinary action from the nursing program.

• For additional information on how to use social media without professional or personal repercussions, visit: https://www.ncsbn.org/2930.htm

Used with permission, Dr. Margi Schultz, April 29, 2014

Appendix B

Lewis and Clark Community College School of Nursing Contract of Social Media Conduct

In exchange for the educational opportunities provided to me by the clinical rotations, I agree to comply with all

147Educate, Excite, Engage

state, local and federal requirement governing the privacy of medical information. Those privacy requirements have been explained to me, and I have had training in complying with these requirements. I agree to uphold all HIPPA and other privacy requirements during my clinical rotations.

I understand that I am bound to comply with all privacy requirements when I am not at the clinical rotation, including in my conversations with family, friends and peers. I will be held accountable for maintaining the privacy of any information I obtain, see, or am given during my clinical rotations. To uphold the privacy of such information, I agree to not post or discuss any clinical experience or information regarding my experi- ence with the clinical agency, its staff, or its clients/ patients on any internet social media (Facebook, Twitter, emails, MySpace, and any others not mentioned). I understand that administration periodically searches the internet for breaches in its privacy policies. I will be prohibited from returning to the clinical site if I violate any privacy requirement in any regard. Such violation may also result in a delay in completing my degree requirements or in further disciplinary action against me by Lewis & Clark Community College.

D a t e : ____________________________________________

Student Name (print):____________________________ ________________________________

Student Signature: ______________________________ ________________________________

Used with permission, Donna Meyer, April 29, 2014

Tim J. Bristol PhD, CNE, ANEF Walden University

E-mail address: [email protected]

References Glauser, W. (2013). Doctors among early adopters of Google Glass.

Canadian Medical Association Journal, 185(16), 1385. Mayo Clinic (2012). Social media health network: Health care social

media list. Rochester, MN: Author (Retrieved from: http://network. socialmedia.mayoclinic.org/hcsml-grid/).

National Council of State Boards of Nursing (2011). White paper: A nurse's guide to the use of social media.Chicago, IL: Author (Retrieved from: https://www.ncsbn.org/2930.htm).

Peck, J. L. (2014). Social media in nursing education: Responsible integration for meaningful use. Journal of Nursing Education, 53(3), 164−169.