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December 2011, Volume 41 Number 12 , p 12 - 13


  • Susan A. Salladay PhD, RN


After graduating from nursing school, I volunteered for a church mission trip to Mexico, where I made wonderful new friends. I've kept up my contacts on Facebook. One young man I met has asthma. He often describes his exacerbations and breathing difficulties and asks for my opinions. I don't think he's getting appropriate healthcare, but I'm reluctant to say so online. What's my ethical responsibility in this situation?-V.C., ARIZ.As the term social networking implies, its nature is social, not professional. You cannot, and should not, have a professional healthcare relationship on Facebook, Twitter, or any other social network. You can't be a nurse on Facebook, only a friend.As a new nurse, you'll need to set clear boundaries between your professional and social actions. Make certain you understand and respect the differences.As you know, information on Facebook isn't confidential. Even giving friendly advice can be risky. Language nuances, physical descriptions, and emotions aren't captured easily and accurately through texting, blogging, and social networking. With so many opportunities for misunderstandings, safety can be compromised. Tell your friend, kindly but firmly, that you can't provide health advice, and stick to your guns.Recently a nursing colleague came to work with significant facial bruises. Knowing a little bit about her personal life, I suspected intimate partner violence (IPV), a problem I see all too often in my position as an ED nurse. During a private moment in the break room, I asked her what happened and she blew up at me. "Just because you think you know what's happening with patients doesn't give you the right to make assumptions about my appearance, so stop jumping to conclusions!" Now she's angry and won't even speak to me. What should I do?-P.N., HAWAIIYour best strategy is to start with an apology. This can show your colleague that you're indeed sorry if you jumped to the wrong conclusion. More importantly, it allows her to recover dignity

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