Have you used social media to complain about colleagues?
Doctors are being told to watch what they tweet as hospital staff are disciplined for social media incidents - including posting medical photographs and patient notes on Facebook.
The Medical Council is advising doctors to bone up on social media protocol, as the increasing number of medical professionals using sites such as Facebook, Twitter and LinkedIn give rise to privacy dilemmas.
Documents obtained by The Dominion Post under the Official Information Act show doctors and nurses in hospitals nationwide have been disciplined for overstepping online boundaries.
The Waikato District Health Board dealt with five incidents last year alone.
In one case, a nurse posted an image of a patient's clinical notes on a Facebook page for another colleague to review.
The patient was not identified and the nurse was spoken to about acceptable social media usage, human resources general manager Fiona McCarthy said.
In another incident, a staffer put an "adverse comment on Facebook about a co-worker", and two colleagues "liked" the comment. The doctor and two nurses were all cautioned.
Another nurse received a final written warning after making derogatory comments about workmates on Facebook, while an Allied Health professional received a written warning for complaining about their workmates and environment.
With more than 6000 staff at the DHB, the number misbehaving on social media was small, Ms McCarthy said.
"We believe that is because we constantly remind our staff of their obligations, and staff are vigilant and well aware of patient rights."
In Wairarapa, a medical staff member was given a warning for posting "inappropriate discussion and photos of a medical nature" on Facebook.
And Hutt Valley DHB conducted an internal investigation after a nurse lodged a formal complaint against a colleague for harassing another workmate in a Facebook discussion.
The investigation found five nurses had been engaged in "banter and joking", which ended after management spoke to them.
At the same DHB, an Allied Health clinician had to attend a "corrective interview" after posting a clinical blog.
The clinician shut down the site immediately and resigned soon after, DHB chief executive Graeme Dyer said.
At Hawke's Bay DHB, a staff member was disciplined for an "inappropriate" posting on their own Facebook page, and another for posting incorrect information on the Nurses Organisation's Facebook page. Both received written warnings.
Other incidents included the Facebook posting of "potentially inappropriate patient-related information" by a Waitemata District Health Board nurse, and a nurse who discussed "occurrences" during an overnight shift at Middlemore Hospital.
Medical Council chairman John Adams said doctors needed to remember that rules around patient confidentiality and ethical behaviour did not change online.
"They need to understand that once the information is in the public space, then it is out of their control. If you are posting patients' information on Facebook, that would be a very serious breach of privacy."
Nurses Organisation nursing policy adviser and researcher, Jill Clendon, said some nurses were "grappling" with the pitfalls of social media use.
The union had created social media guidelines last year, and had been holding workshops at hospitals.
Christchurch Polytechnic Institute of Technology nursing head Cathy Andrews said appropriate social media use was drilled into its 1000 students.
Several students had been disciplined for misuse, most of it accidental, she said.
"We've had some situations that . . . well . . . particularly nursing uniforms can create some interesting dynamics. They just need to think about what image it is portraying of them as a professional."
Live-tweeting heart surgeries and offering online consultations may be the way of the future.
Last year, doctors at Houston's Memorial Hermann Northwest Hospital live-tweeted a double coronary artery bypass on a patient. Followers could view more than 100 tweets and photos from the successful surgery.
Elsewhere, New York "Doctor of the Future" Jay Parkinson has a virtual practice, where patients can plug in symptoms online.
He aims to eventually work from a Facebook-like platform, diagnosing via video chat and instant messaging.
A New Zealand Doctor survey in March found 55 per cent of GPs used Facebook. In 2011, it was 30 per cent. Less than 10 per cent used Twitter.
- © Fairfax NZ News
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