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'NHS bosses must master Twitter, Facebook to halt staff antics'

Top adviser hits out at 'social media refuseniks'

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The author of recent guidance on using social media for nurses and midwives says NHS managers should be able to actively respond to issues around how their staff use social media.

Andy Jaeger, assistant director of public and professional communications at the Nursing and Midwifery Council (NMC) and author of recent guidance on social media, says that NHS managers must be better equipped to handle issues around social media.

The regulator has seen an increase in the number of enquiries from nurses and midwives about social media and referrals that directly relate to social networking, but despite this there are still managers who are "social media refuseniks".

"One of things that we say in our advice is that if a manager has responsibility for investing in a complaint about the use of a social networking site, that they should join the social networking site so that they understand the mechanics of how it works. People need to familiarise themselves with this kind of thing," he says.

"I think actually what it needs is a robust response at a local level. In our advice much of what we've done is interpret the standards that already exist around conduct, performance and ethics. We're just helping people to understand what it is that is going on and then act appropriately."

But he says: "that really is better done not with a set of national guidelines from the Department of Health, but with local managers taking responsibility and understanding the issue and dealing with it for themselves."

Last month a snapshot survey of some of England's biggest trusts by the Guardian's healthcare network showed that 72 separate actions were carried out by 16 trusts against staff who inappropriately used social media between 2008-09 and October 2011, suggesting social networking sites are presenting some challenges to the health service.

Jaeger say one of the things that prompted the guidance over the summer were questions from employers about issues of confidentiality and when it was appropriate or not to be friends with a patient on Facebook. This led to guidance being created largely based on the NMC's code of conduct for nurses and midwives.

"We heard from students, nurses and midwives about the inconsistencies in the way that their managers were dealing with problems that they were raising about colleagues or other students' use of social networking sites," Jaeger says. "So some of what we've included in our advice is around the managers who are having to deal with these issues. It's actually for them to have some understanding of social networking sites and how they work, but also to take the issues that are raised with them as seriously as if they had happened in a real world scenario."

The British Medical Association (BMA) also issued guidance around the same time as the NMC as it said it felt that with more people using social media, advice and guidelines were lacking.

The NMC's guidance has proved a success among healthcare professionals, and the guidance has received 50,000 page views since it was published in July.

From his own experience, Jaeger explains that while there are some managers who use Facebook and Twitter, there are some that are "social media refuseniks". This becomes an issue when these managers fail to understand the ethics around social media, which makes it hard for them to tackle problems that arise as they might not see why something may be inappropriate.

Jaeger says: "When I've given talks on this I've used the example of somebody taking photographs of their colleagues, changing them and putting rude captions on them and sharing them online.

"If you view that as seriously as if somebody had done that and pinned it on a staff noticeboard, it gives you as a manager a better steer about how important it is that you deal with those kinds of things robustly and not just think because it happened on a social networking site like Facebook that it's not important, because it is."

Jaeger says he believes that staff misuse of social media is largely unintentional, but there are cases that the NMC deals with which are "absolutely deliberate" – which is perhaps not surprising given that the regulator deals with referrals relating to nurses and midwives that may not be fit to practice. Such instances include pursuit of relationships with patients and bullying and harassment of colleagues.

Looking to the future, Jaeger says that the NMC is currently helping the British Psychological Society to produce its own set of social media guidelines for psychologists. He says the NMC is also interested in encouraging healthcare professionals to use social networking sites to positively engage with patients and share good health stories. He adds that it would be disappointing if some health professionals stayed away from sites like Facebook just because they were scared of misusing it.

"We're starting to think about, organisationally, the kind support we can give to nurses and midwives who are positively using social media as a way of talking about health," he says. "There are potentially so many positive benefits. It's an area we're looking at, and we'll be publishing something in the new year on the subject."

This article was originally published at Guardian Professional. Join the Guardian Healthcare Network to receive regular emails on NHS innovation.

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