Nursing Ethics and Behavior in Social Media


Social media offers a convenient platform where people can connect with friends and family. It also makes the world a global village where people enjoy interconnectedness regardless of time and space. In learning, students can communicate easily with each other and discuss important issues concerning their education (Tuckett & Turner, 2016). The possibilities for communication and connectedness offered by social media are enormous and endless.

However, if not used properly, social media is a destructive tool with lasting negative repercussions. For instance, a children’s hospice nurse named Allison Hopton was suspended from the nursing profession for six months after posting a series of derogatory messages on Facebook. In her defense, she claimed that she thought Facebook was a place where she could vent (“The Press Association,” 2013).

Additionally, she noted that her posts were personal and thus not connected to her work. She was reported to the Nursing and Midwifery Council (NMC), which found that the profane messages posted on social media had both explicit and implicit references to the hospice where she was working (“The Press Association,” 2013). She later admitted her mistakes and proceeded to serve her ban. This paper explores the nursing ethical issues surrounding this incident.

Immediate Action

Assuming I have a classmate called John and I came across his Facebook post making derogative, disrespectful or threatening comments about one of my lecturers, I would immediately contact the person behind it. I would seek to understand why he is posting such messages. Most people do not understand the seriousness of the messages that they post online. Therefore, I would ask John the motives behind his actions. Perhaps he would just be venting like Hopton in the case study. I would then advise him to take down the posts because it is disrespectful, unprofessional, and unethical to do such a thing as a nurse, especially after going through the numerous codes of ethics that should be observed in the profession. I would send him a copy of the registered nurse standards for practice.

Subsequent Actions

If John heeds my advice and takes the posts down, I would arrange a meeting where we can talk about the consequences of his behavior. I would assume the role of a leader and take him through the codes of ethics governing the nursing practice. Even though the posts have nothing to do with the nursing profession, I would make him understand that the probability of perpetuating such habits when dealing with patients is high.

To emphasize my point, I would refer to the case of Allison Hopton and hope John acknowledges the adverse repercussions of misusing social media as a nurse. I would reiterate the importance of upholding other people’s dignity even when we differ in opinions or beliefs. According to Edge (2017), most students do not understand the repercussions of what they post on social media. With this knowledge, I would engage in a campaign to sensitize them on how to use it appropriately. However, if John declines to remove the posts, I would inform the affected lecturer to take the appropriate actions.

Most Applicable Sections

According to the Code of Conduct for Nurses by the Nursing and Midwifery Board of Australia (2018), nurses are expected to engage with other people as individuals respectfully and observe professionalism under the third principle of the code. The second subset of the third principle requires nurses to acknowledge how their culture, beliefs, attitudes, assumptions, and values affect the way they interact with other people.

Part D requires nurses to “create a positive, culturally safe work environment through role modeling and supporting the rights, dignity, and safety of others, including people and colleagues” (Nursing and Midwifery Board of Australia, 2018, p. 8). In this case, John would have violated this provision by choosing to post derogative messages concerning our lecturer. Such behavior robs our lecturer of his dignity, which is against the set rules.

Even if John was genuinely offended by the lecturer, based on this provision, he should have respected the dignity of the offender and air his views differently. The third subset of the third principle outlines the use of effective communication. Part F urges nurses to “be non-judgmental and not refer to people in a non-professional manner verbally or in correspondence/ records, including refraining from behavior that may be interpreted as bullying or harassment and/or culturally unsafe” (Nursing and Midwifery Board of Australia, 2018, p. 8). John would have applied this principle by not being judgmental. The principle requires nurses to refrain from anything that can be interpreted as harassment.

The fourth subset of the third principle discourages any form of bullying and harassment. The provisions of this requirement are categorical on what can be termed as bullying. The first section that requires intolerance to anything related to bullying applies to me. The provision demands nurses not to engage in, ignore, or excuse such behaviors (Cashin et al., 2017). Therefore, by reaching out to my friend to understand why he is posting such messages, I would be following this requirement.

I would not ignore such posts and say the issue does not concern me. Additionally, I would not excuse John’s behavior, which explains my earlier stand of communicating and letting him know that whatever he is doing is wrong. Part B of this section tells nurses to “recognize that bullying and harassment take many forms, including behaviors such as physical and verbal abuse, racism, discrimination, violence, aggression, humiliation, pressure in decision-making, exclusion and intimidation directed towards people or colleagues” (Nursing and Midwifery Board of Australia, 2018, p. 8).

Posting demeaning and threatening messages about someone amounts to bullying and harassment. Therefore, John would be intimidating and provoking my lecturer. Part C highlights the fact that social media is at times used as an avenue for promoting bullying and harassment. John would be clearly using social media to propagate unethical conduct, which should be dealt with according to the laid down procedures. The last part of this section requires nurses to escalate their concerns if the meaningful response is not forthcoming. This provision fits well into my actions of informing the affected lecturer if John is not willing to delete the posts.

The International Council of Nurses Code of Ethics for Nurses has four elements, and two are applicable in this case. The first element addresses how nurses should relate with other people. As such, nurses are required to “demonstrates professional values such as respectfulness, responsiveness, compassion, trustworthiness, and integrity” (International Council of Nurses, 2012, p. 2). Under this provision, John would have violated the values of respectfulness.

In a nursing practice scenario, it means that he would use social media to air his differences with patients. He would even share a client’s confidential information through social media as a way of venting or revenging, which is a breach of privacy, and it attracts serious repercussions like the revocation of a nurse’s practicing license. The fourth element of the ICN outlines how nurses should relate with co-workers. In this case, our lecturer would fall under the category of a co-worker.

This element requires practitioners and managers to “develop workplace systems that support common professional, ethical values and behavior” (International Council of Nurses, 2012, p. 9). In this context, sharing threatening and derogative messages about a co-worker violates the principle of professionalism and acceptable behavior.

Finally, the second provision of the registered nurse standards for practice by the Nursing and Midwifery Board of Australia (2017) requires nurses to pursue professional relationships. As such, one is supposed to be respectful of other people’s dignity, culture, values, and beliefs. In the case of posting demeaning messages, John would have violated all these provisions. As a nurse who upholds professionalism, one should not attack others, whether verbally or physically, regardless of the nature of the trigger factors.

The nursing profession is changing quickly, and with globalization, the workplace is becoming dynamic as occasioned by arising needs from diverse patient backgrounds (Kettering, Lowe, & Stewart, 2013). Therefore, one may be hurt emotionally in the process of handling a given case or differ with a patient. These differences are bound to occur, but how one chooses to handle or respond to such issues determines the outcome.

Therefore, the response chosen should always be in line with the stipulated codes of ethics that govern the nursing practice. In the case of John, perhaps he was hurt genuinely by our lecturer’s comments or behavior. However, under the principles set forth by the nursing code, one is required to respect other people’s sentiments and beliefs. Therefore, John should have respected the lecturer’s beliefs. If he feels that our lecturer acted in an unbecoming manner that violates the working principles, then he would have escalated the issue to the relevant authorities for appropriate action to be taken.

John can be sued for causing defamation, menace, and harassment through social media. It is a criminal offense to perpetuate such behavior, whether on social media or in person. In the future, John may not be considered for job positions due to his misconduct. Currently, employers are looking at one’s use of social media to make decisions in the hiring process. Therefore, future employers may be concerned that John would perpetuate the same behavior in the workplace and thus turn down his job application request.

Conclusion

Social media is one of the revolutionary inventions of the 21st century, and people are connected in different ways today than at any other time in the history of humanity. However, such an opportunity to share information with friends and express one’s feelings should be used with care to ensure that other people’s beliefs are respected.

Allison Hopton used social media carelessly, and even though the information she posted was not related to the patient’s privacy or data, it reflected a lack of professionalism, which explains why she was reprimanded and suspended from the nursing practice for six months. If John posted demeaning and derogatory messages on social media about one of my lecturers, it would imply a lack of respect and unprofessionalism. I would caution him, and in case my warnings are unheeded, I would report the matter to the affected lecturer for the necessary measures to be taken.

References

Cashin, A., Heartfield, M., Bryce, J., Devey, L., Buckley, T., Kerdo, E., … Fisher, M. (2017). Standards for practice for registered nurses in Australia. Collegian, 24(3), 255-266.

Edge, W. (2017). Nursing professionalism: Impact of Social media use among nursing students. Journal of Healthcare Communication, 2(3), 28-30.

International Council of Nurses. (2012). The ICN code of ethics for nurses. Web.

Kettering, I., Lowe, M., & Stewart, C. (2013). Ethics and law for the health professions (4th ed.). Annandale, NSW: Federation Press.

Nursing and Midwifery Board of Australia. (2017). Registered nurse standards for practice. Web.

Nursing and Midwifery Board of Australia. (2018). Code of conduct for nurses. Web.

The Press Association. (2013). Nurse suspended over Facebook posts. Nursing Times. Web.

Tuckett, A., & Turner, C. (2016). Do you use social media? A study into new nursing and midwifery graduates’ uptake of social media. International Journal of Nursing Practice, 22(2), 197-204.