The Australian Health Practitioner Regulation Agency working in partnership with the Nursing and Midwifery Board of Australia has released a consultation paper on its new Social Media Policy
Frankly, it is pretty unsettling.
In fact if it is published in its present form, impactednurse.com will immediately be in breach of it (As will my Twitter feed, and my Facebook page).
The National Boards have developed the policy to clarify the National Boards’ expected standards relating to social media use. The recent advent of social media, and its expanding use from a social networking tool to a medium for commercial/business related information sharing and advertising, has prompted the need for clarity. The development of the policy has been supported by requests from health practitioners and professional associations seeking guidance from the National Boards on this issue….
…. The primary role of the National Boards is to protect the public. The Health Practitioner Regulation National Law, as in force in each state and territory (National Law), and codes and guidelines developed by National Boards are relevant when considering social media.
You can download the Consultation Paper (pdf) (Update: the policy has been removed from the previous link but you can still download it here) to read through yourself. But I will just tease out a few sections of the draft to examine (all bold print is mine to highlight areas I have some concern about):
1.1 Professional Boundaries
Registered health practitioners should be aware that online relationships or relationships through
social media are no different to more direct forms of relationships. Disclosing personal information on social media to current or former patients may breach professional boundaries.
Practitioners should avoid non-therapeutic online relationships with current or former patients. For this reason, practitioners should be wary of accepting friend requests from individuals or organisations unknown to them.
Comment: My own site is full of personal information. Information about my private life, my dog, my partner, my holidays and of my experiences during those all too brief periods that I do not have a stethoscope within arms reach.
Oh yes AHPRA there are even stories about my sex life (if you care to dig for them).
I have quite a few people following my Facebook page, I have around 1,500 subscribers that get impactednurse.com delivered via email. Are some of these people individuals or organisations unknown to me?
Have I had conversations with some of them in the comments section and via emails?
1.2 Professional behaviour
As in any other context, registered health practitioners should act in a professional manner when using social media. While respect and good communication with colleagues and other practitioners enhances good care, critiquing or comparing and contrasting other health services does not.
Comment: In the past I have critiqued, compared and contrasted other health services as well as my own. I think it is incredibly important that nurses are allowed to have a voice on social media, a voice that is free to make ethical, sensible and relevant comment in the public interest, in representation of our profession and as a patient advocate.
We must be hardcore on this. Sometimes good communication involves rubbing up against the status-quo.
2 Confidentiality and privacy.
Registered health practitioners have an ethical and legal responsibility to maintain patient privacy and confidentiality. Practitioners should not make comments about patients on social media, even in a de- identified way, as it may breach the patients’ privacy and confidentiality.
Comment: This is always a delicate matter, and I think most bloggers who have been around the block have have now developed a clear understanding about privacy and confidentiality. We still sometimes get it wrong. But honestly, I think we get it nowhere near as wrong much of the mainstream media and a few of the healthcare organisations themselves.
If we cannot discuss patient issues in a de-identified way, much of the valuable teaching using case studies, reflective practice, cautionary tales, that the best blogs and websites develop will be lost.
I feel very strongly on this point.
All, and I will put this in capitals… ALL of the most useful skills and quality knowledge I have learned, reflected on, discussed and passed on in the past 5 years or so has come from some form of social media source.
When using social media, health practitioners should remember that the National Law, Advertising Guidelines and the code of conduct apply.
Registered health practitioners should only post information that is not in breach of these obligations by:
• not breaching professional obligations
• not breaching confidentiality and privacy obligations (such as discussing patients or posting pictures of procedures, case studies, patients or sensitive material)
• presenting information in an unbiased, evidence informed context and not making
unsubstantiated claims and
• not using testimonials or purported testimonials in any capacity on any medium.
Comment: Again, case studies are a valuable learning tool utilised by all the best medical bloggers.
Many teaching sites now use de-identified pictures and/or videos of procedures.
And as for the definition of sensitive material……well that could be open to pretty wide interpretation.
AHPRA may dropped right off the wave here. The whole guideline should be re-written from an affirming rather than a punitive point of view.
Of course there must be standards and safeguards for both public and our colleagues. But lets work towards developing and nurturing social media not desiccating it.
The positive and beneficial results that social media can bring (and has brought) to our patient care is many orders of magnitude greater than any damage it has caused to the public. The medical profession remains in a social media nascence at this time. Sites such as Life in the Fast Lane and many others are making huge advances in delivering quality evidence based education and forums for interaction and cross-fertilisation of knowledge.
Interactions I have had with nurses, doctors and healthcare consumers both on this blog and in other social media streams, have at times been, uplifting, inspirational and transformative in my own professional practice: we>me.
I would really appreciate you taking a look at the draft policy yourself and voicing your own opinions on it.
Right now I am tired, and perhaps a bit oversensitive about the whole thing. Perhaps it is after all, just another guideline we need to keep us all on track.
What say you?
AHPRA is asking for feedback by email (email@example.com) by close of business on 14 September 2012.