Introduction: Smartphones and computer tablets are commonplace among nursing students, nurses, physicians and other healthcare providers. It has made communication less complicated and replaced other outdated communication technologies. A significant proportion of U.S population uses smartphones. People rarely think about its ethical and legal implications. Many healthcare providers have policies that enable the protection of their client and practices from harms caused by the use of these devices. (Thomas, McIntosh and Edwards, 2013)
The scenario about the leak of a celebrity photo, through the smartphone of a hospital staff, that was presented in the classroom, is an example of how smartphones in hospitals can harm client privacy. Smartphones and tablets, like any other technology, enriches life in the hospital and thus cannot be banned. According to a statistic, 75% of the nurses owns a smartphone and 60% use smartphones or similar mobile devices, in conjunction with patient care. Texting is particular important part of social communication. In the scenario that was discussed in the classroom, a text message from the nurse to a friend, triggers the onset of a crisis that breaches patient safety and security. Messages and pictures stored in smartphones can be read and forwarded by anybody, if they are not protected. For these reasons, the Joint Commission, has taken action to ban physicians and hospital staffs, from using smartphones and related mobile devices, for sending medical information. According to the commission, 20,000 hospitals in U.S were certified of practicing safe technology in 2013. The commission does not ban the sending of messages completely. Hospitals can send medical messages in a secure way. HIPPOmsg and Tiger Text programs are some example of secure messaging platforms. (Beard, 2013)
Unlike in the past, access to medical information is not restricted to healthcare professionals. Today, patients or even the general public, can access healthcare information through internet and hospital portals. Patients can use smart phones to record information about a medical procedure or a conversation in the hospital. Students use smart phones to video record or take photographs related to a case. All this information collected from the hospital can become problematic if they fall into the hands of people who can cause trouble. Thus, all these information needs to be protected. To do this, hospitals and healthcare, develop policies that restrict the use of smartphones in the hospital premises. Protecting hospital information and preventing leaks of private information, is important for building patient and physician trust. A patient who is not comfortable with the overuse of smartphone and lack of privacy, may hesitate from opening up and providing the doctor with necessary information. A physician, who is threatened by the information used in smart phone may venture to practice defensive medicine. In addition, use of smart phones and mobile devices in surgery premises can pose safety risks to patients.
Another important concern with the use of smartphones is that the user rarely seeks permission to record information or conversation. Smartphones are loaded with many social applications and very often the recorded images get instantly uploaded to the social network, providing many with unrestricted access to private information. Confidential information can get inadvertently exposed, with lack of conscious use of smartphones. This happens when people like fidgeting with the cell phones all the time. Though it may be a stress bluster, it may accidentally affect healthcare safety. In spite of displaying signs to switch off the cell phone before entering doctors cabin, very few patients care to follow it. (Paton et al., 2011)
We live in an era of nursing informatics, where most of the information in the field is communicated electronically, through wireless networks. Electronic health records are expected to improve healthcare efficiency. Electronic health records are identified and adopted as a smart way of saving and sharing information. The information stored in electronic format can save time spend in searching records, save paper and enhance accessibility. Nursing informatics is a field of nursing’s that aims to use the information that are stored in electronic format, in a useful and innovative way. Students are provided access to this information, as part of the training process. Texts and study material are read by students in an electronic format. This electronic information is accessed through electronic devices like smart phones and tablets, and thus banning their use will affect the educational process. Using technology has become as important as critical thinking in nursing. Security policies, will prevent students and other employees from using the patient information in the wrong way. In addition, intense use of electronic communication, can deprive the students the benefit of actual socializing and studying of body languages. The information stored in electronic format is also at risk of theft by viruses, worms, and hackers, who target online information. (Paton et al., 2011)
As more and more people are turning to the internet to seek information, putting up faulty information can mislead the patients and lead to fraudulent practices. There is a need to educate people on ways to seek credible information. There is also a need to create a safe environment for online browsing. People seeking information from the website must ensure that the source of information is authentic and is provided by a health or research source. They should also make an effort to understand the objective of displaying the information on the internet. Any information that is provided to sell a product will be biased. Hence it is necessary to know the sponsor of the information and the advertiser as well. These are few best practices in networking. Likewise, best practices when communicating electronically can help prevent confidential information from reaching wrong hands. Using specific subject line and addressing the email or messages correctly to the intended recipient will prevent reading of messages by random people. Using a virus protection program that is up-to-date will prevent information theft. Avoid sending confidential information online, unless both parties agree to do so. If the sender seeks immediate reply with the information, it is better to use other faster form of communication, like calls or text messages, rather than using email. (Thomas, McIntosh and Edwards, 2013)
Social networks are places in the internet, where people create online communities to share personal information, ideas and other contents. Users of these web based services, can create a public/semi-public profile within a bounded system, and articulate with other users to whom one is connected through the web service. The user can view and participate in the conversations, happening in social media. Social media can reflect the conversations that happen at a local level. For example, conversations that happen in the ward, in the cafeteria, in the changing room; happens in social media, but unlike that of a local setting, these conversations are displayed to a wider audience. Being a highly interactive platform, healthcare sector can use it for improving public relations. Issues and problems all over the world could be communicated and discussed through social media. The things said through social media are often taken more very seriously than those said during real life conversation. Twitter, Facebook, Instagram, Youtube, Linked N, Pinterest, Last Fm and G+ are example of popular social media. (Beard, 2013)
Social media has many positive functions. It helps people to remain connected, even when they are physically far away. Being connected helps keep up with the trends and jobs. It can help build contacts and opens up new opportunities. You can establish a number of contacts through social media. Many social media apps, do not limit the number of contacts a person can make. It helps combat loneliness and provides an opportunity to peep into others life. The interactive discussions in social media can be used for learning, or to research ideas and topics. It is also a good tool to collect polls or surveys. Many hospitals and healthcare services have accounts in social media and use it to connect to a wider audience. (Beard, 2013)
While social media is appreciated for its role in enhancing the experience of nursing practice and education, it is also equally criticized for providing an opportunity to post inappropriate pictures or messages about fellow colleagues or patients. Very often the behavior of colleagues or co-workers are discussed on Facebook and there has not been any strict policies to prevent it. Few people, also use it to pursue sexual relationships. Facebook profile and interaction are sometimes traced by recruiting agencies to gain information about the candidate. Though people tend to rely on facts said on Facebook, in many instances, it is not possible to confirm the validity of these things. Social media are developed to increase publicity, and thus one cannot expect them to protect one’s privacy. Thus the user must be judicious about the content one post on these social media networks. There are various instances where disciplinarian action was taken against nurses for posting inappropriate content on the internet. In one instance a nursing student was banned from using social media, as she posted nude photos of patients in the network.
Conclusion: Unethical and unprofessional conduct in social media can invite trouble. Similarly, revealing a privileged content and breaching confidentially is prohibited by healthcare social networking policies. Criminals can use contents posted on the web to schedule crime and thus it is unsafe to display critical information. Many social network users spend more time online during working hours, and this eventually affects performance at work. To avoid this, employers, use devices and techniques that enable tracking the time spent online. Nurses should remember that they represent the integrity and reputation of the profession when they are online and thus should conduct themselves appropriately. They can also inform colleagues, family and friends to refrain from posting content that can affect privacy.
Beard, E. (2013). Nurse Leaders and the Use of Social Media: Becoming Literate to Lead. Nurse Leader, 11(6), pp.38-40.
Paton, C., Bamidis, P., Eysenbach, G., Hansen, M. and Cabrer, M. (2011). Experience in the Use of Social Media in Medical and Health Education. University of San Francisco USF Scholarship Repository.
Thomas, C., McIntosh, C. and Edwards, J. (2013). Smartphones and computer tablets: Friend or foe?. JNEP, 4(2).