I had other plans for my final post in this blog series. I was going to write about social accountability, but then I received a message from a friend in my PhD cohort. The verdict for the disciplinary hearing of Carolyn Strom was online and spreading through news outlets.

Last February following the death of her grandfather, Carolyn published a Facebook post that has since been the subject of intense scrutiny by her regulatory association. In it she praised some of the staff members who cared for her grandfather, but also voiced that some staff members didn’t seem “up to speed” on palliative care.1 She went on to warn those with loved ones at this institution to advocate if anything seemed amiss. Another nurse reported the post to the Saskatchewan Registered Nurses’ Association (SRNA), which is the regulatory organization for registered nurses and nurse practitioners in Saskatchewan. Carolyn was subsequently accused of professional misconduct. After months of deliberation, in October the discipline committee reached a decision; guilty of professional misconduct.2

Initially one of the charges was violation of confidentiality, although this charge was ultimately dropped. The SRNA alleged that Carolyn had violated patient confidentiality because she publicly shared information on her grandfather’s care. She maintained that she was posting as a granddaughter, not a nurse. I imagine this charge was eventually dropped because Carolyn wasn’t her grandfather’s nurse, so you really can’t make the claim that she violated patient confidentiality. Ironically, purportedly the SRNA had at one point published a portion of the Facebook post on their website without removing the identifying data, which violated the Health Information Protection Act.3

There were a number of other specific charges, including failure to follow proper channels for making a complaint, impact on the reputation of facility and staff, and failure to first obtain all the facts before disseminating her conclusion.2 All of these charges can only exist because of the fifth accusation; using her status of Registered Nurse for personal purposes:

“By identifying yourself as a registered nurse you have engaged your obligation to abide by the standards and code of ethics of your profession.”2

As discussed in eProfessionalism, identifying as an RN (or another healthcare profession) can extend one’s professional responsibility. Unfortunately, this case is an example of how the distinction between professional and personal is shrinking due to the digital world.4 While Carolyn maintained that she was posting on a personal rather than professional level, the SRNA felt otherwise because her status as an RN was brought into the conversation.

I can’t help but wonder what exactly this means for nurses with social media accounts. Can someone be accused of unprofessional conduct if their being an RN is mentioned anywhere on their account, including buried somewhere in their newsfeed? Or just in relation to that online conversation? My Facebook friends all know that I’m an RN. Does this mean I must adhere to the CNA Code of Ethics at all times? Where does the personal end and the professional begin?

When I read through the Facebook post in question, I see a grieving granddaughter rather than someone who has her nursing cap on. Could she have been more professional? Yes. But I think it’s unfortunate that things escalated to this level. This could have been approached as an education opportunity for this particular nurse (and nurses more broadly) on social media and eProfessionalism. Hopefully the SNRA, Canadian Nurses Association and other professional bodies will view this as an opportunity to review their guidelines and policies on social media use in nursing. With any luck, the upcoming revision to the Code of Ethics for nurses will contain more guidance on social media. I believe nurses, administrators and patients will all benefit from RNs receiving more guidance on how to effectively and professionally navigate the ever-changing digital world in their personal and professional lives.

 

References:

  1. CBC News. Sask. nurse charged with professional misconduct pleads not guilty. February 15, 2016. http://www.cbc.ca/news/canada/saskatoon/not-guilty-plea-from-sask-nurse-over-facebook-post-1.3449537. Access December 3, 2016.
  2. Saskatchewan Registered Nurses Association. SRNA discipline decision: Strom. October 27, 2016. http://www.srna.org/images/stories/RN_Competence/Comp_Assurance_Hearings/SRNA_Discipline_Decision_Strom_Redacted_Oct_27_2016.pdf. Accessed December 3, 2016.
  3. Metro News. Nurse guilty for complaining on Facebook about grandparents’ care. December 2, 2016. http://www.metronews.ca/life/health/2016/12/02/nurse-guilty-for-complaining-on-facebook-about-grandparents-care.html. Accessed December 3, 2016.
  4. Hillman T, Sherbino J. Social media in medical education: a new pedagogical paradigm? Postgrad Med J. 2015;91(1080):544-545.
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