This article appeared in the February 2015 OR Manager written by Cynthia Saver, MS, RN
Privacy violations, work distractions, wasting time—with all these risks, who needs social media?
Social media is key for OR leaders to successfully manage their professional lives. Savvy leaders accept that social media is a two-sided coin.
“The reality is that every post, Tweet, and text is filled with the opportunity for both reward and risk,” says Keith Siddel, PhDc, JD, MBA, CHC, an attorney and healthcare finance and compliance expert based in Monterey, California.
You need to know how to minimize risks while reaping rewards such as connecting with colleagues and experts around the world, landing a job, and finding solutions to your problems. Here’s how to do it.
Know your purpose
Where you spend your time in social media depends on your goals. “There are really two different approaches,” Siddel says. “One is professional development, and one is a work dialogue.”
If you are seeking professional development, you should be on LinkedIn, which lets you share your expertise, display your accomplishments, and, as Siddel says, “show your professional face to the world so people know who you are and can quickly identify what your expertise is.” LinkedIn is the first social media choice for job searching among healthcare professionals (sidebar, p 19).
Work dialogue consists of sharing ideas and seeking solutions. In this case, Siddel recommends resources such as user groups. A user group for Epic OR software, for instance, would be an ideal place to discuss how to more efficiently use the system. Other options include allnurses.com and, for OR Manager subscribers, ORBusinessmgmt_listservefirstname.lastname@example.org.
Siddel welcomes the new opportunities for dialogue. “Ten to 15 years ago you didn’t know what others were doing because there was no platform to share information. You had to pick up the phone,” he says. “Now we have a global professional neighborhood. OR managers can share information, dialogue, and exchange experiences. It makes for a much richer exchange, information flows faster, and it feels like we’re part of a community.”
Segregate your apps and peeps
Siddel recommends segregating your friends and family from business acquaintances and associates. One method is to separate the apps that you use. Apps best suited to personal friends include Facebook, Tumblr, and Pinterest. LinkedIn is more appropriate for business contacts.
“Twitter can be for either professional or personal use,” Siddel says. “Pick and choose how you’re going to use it.” One benefit of Twitter is that Tweets are often re-tweeted to a very large audience.
Google Plus and Facebook allow users to aggregate contacts into circles (in the case of Google Plus) or lists (in the case of Facebook). Users may also create two accounts, one professional and one personal, although Siddel doesn’t recommend this option. “It’s easy to make a mistake if you don’t know that every time you go there it’s personal or every time you go there it’s professional,” he says. “It’s better to make a choice.”
OR leaders can use social media to engage staff. “Social media is well suited for engaging individuals who are separated by time or space, but need to work on a common project,” says Farris Timimi, MD, medical director for the Social Media Health Network of the Mayo Clinic in Rochester, Minnesota.
For example, an OR manager may oversee ORs that are geographically dispersed, posing a challenge for engagement and education. “To bring all those employees into one space and time would be wonderful, but to do it on a regular basis would be challenging,” Dr Timimi says.
Social media makes communication easier and more practical. He adds that social media helps remove barriers of time and role by encouraging equal participation by overcoming perceived role limitations (for instance, the roles of nurses and surgeons may influence how they communicate) and times that are convenient to individuals.
Dr Timimi recommends taking three steps before implementing social media as a staff engagement tool: establish guidelines, add information to new employee orientation, and educate staff. “When given appropriate guidelines, orientation, and training on how to use social media strategically, employees can be an important asset,” he says.
He shares a Mayo Clinic success story where frontline providers on the cardiology service, including nurses, physician assistants, nurse practitioners, pharmacists, physicians, and discharge planners, can access a tool that lets them have shared conversations related to quality metrics. The tool from Dabohealth.com formats metrics so the display is similar to what users see when using social media platforms such as Facebook.
“The uptick in awareness of quality metrics was significant,” Dr Timimi says. The 252 employees in the program viewed the tool about 4,000 times in 6 months, compared to only 1,400 times for the approximately 60,000 employees not participating.
Consider engagement etiquette
Managers shouldn’t invite staff to be friends on Facebook, but what should you do if a staff member sends you a friend request? “We don’t prohibit that, but I would encourage managers not to accept the request because it raises issues,” says Dan Goldman, legal counsel for the Mayo Clinic.
Managers could feel the need to act on certain entries seen in Facebook. “The better course is to avoid being friends with people you are directly managing unless it’s a close personal friend,” says Goldman.
What if a nurse is promoted from a staff position to a manager role? Should the new manager “unfriend” staff?
“That’s a case-by-case decision,” Goldman says. “If you’re colleagues and have been friends for years, it’s probably less of an issue. It depends on your personal style. Some people might view it [unfriending] as a personal snub.” He adds, “It’s a good rule of thumb that with social media interactions, you want to mirror what’s appropriate in the real-life world.”
Some managers have created a private Facebook page for the unit. Although this can help engage staff, Goldman cautions, “The same rules apply as if you were meeting in a conference room, so you would have to think about how secure that is if there is discussion of identifiable patient information.”
He suggests organizations consider more secure options such as Yammer, which is behind a firewall and is searchable and archived. If the organization invests in the enterprise version of Yammer, additional control and security can be provided.
Understand the characteristics of social media
Speed, scope, and meaning are all characteristics of social media OR leaders need to know about. The world of social media travels at warp speed.
“Once you hit ‘return,’ it’s immediately out there on a wide scale,” Siddel says. “The scope is immediate, it’s worldwide, and there’s no way to take it back.” There’s even a site, Wayback Machine, that archives inactive web pages.
But speed can be a benefit, too. When Siddel was waiting for the Centers for Medicare & Medicaid Services to release the new outpatient prospective payment system rules, the first place he learned of the release was through a colleague’s post on LinkedIn.
Leaders also need to understand that short online conversations, such as Tweets, make it easy for others to misinterpret what is being said. “We need to remember that each piece of the communication can be taken out of context,” Siddel says. “Before I hit ‘send,’ I think about how this piece of information will stand alone.” It’s also important not to text when angry.
Dr Timimi suggests considering the following questions before posting:
• Who am I posting to?
• Is it appropriate for all ages?
• Am I adding to the conversation?
Experts say it’s better to focus on quality rather than quantity of social media communications.
Peter Papadakos, MD, cautions that social media often isn’t meaningful. “Texting is not a rich form of communication. It’s for snippets of information,” says Dr Papadakos, an anesthesiologist and director of critical care medicine at the University of Rochester Medical Center and a professor of anesthesiology, surgery, and neurosurgery in the School of Medicine and Dentistry in Rochester, New York.
He adds that social media should supplement, not replace, face-to-face networking. “Humans are social animals, and we need that interaction.” At a conference, for instance, attendees will benefit more from talking with others who attended a particular session than from hunching over a smartphone and responding to texts, many of which are irrelevant.
Privacy, distraction, and addiction risks
Most healthcare professionals understand Health Insurance Portability and Accountability Act (HIPAA) restrictions, but Siddel says that nurses also need to know state laws related to privacy.
“You’re more likely to violate your state law than HIPAA only because state laws may be more restrictive and have different restrictions than HIPAA,” he notes. Professional associations and state boards of nursing may have information about state privacy rules; a Google search is another option for obtaining this information. Goldman adds that because posts are tagged by location and time, the information can be more identifiable than people think it is, and thus may violate HIPAA or state laws.
The level of distraction imposed by social media is of particular concern in the high-stakes OR environment. “During patient care time, social media has no place,” says Dr Papadakos. “There have been near misses and at least one patient death caused by texting or other social media distraction in the OR.”
Distraction can cross the line to addiction. “Anticipation of the ‘ding’ for a message or text can stimulate dopamine receptors,” Dr Papadakos says. He uses the University of Rochester Modified CAGE Questions to educate staff and outside groups he speaks to about possible addiction (sidebar, p 21).
Risks shouldn’t keep OR leaders from participating in social media. “By knowing risks, you can mitigate risks,” says Dr Timimi.
To reduce problems, it’s best to set limits, he says. Don’t have smartphones on in the OR, educate staff, and have a social media policy. “A social media policy is one of your best risk management tools,” Goldman says. “You want people to have clear guidance as to what’s acceptable and what your company’s expectations are.” (For more information, see OR Manager, December 2014, pp 26-27.)
So what happens if the OR leader or an employee makes a mistake? Goldman says that most social media gaffes are inadvertent.
“People don’t intend to do something bad. They react too quickly and don’t think before they post. People entering the workforce in their 20s have spent half or more of their life on social media, and they fall into that mindset that ‘I’m going to immediately share on social media everything interesting that happens to me, including what happens at work.’”
Goldman suggests that when an infraction occurs, managers should take into account whether the action was malicious or simply a mistake.
Your digital footprint
“Part of being professional means being online,” Dr Timimi says. Not being online cuts off the benefits of social media such as networking and information exchange. However, it’s important to keep in mind that your digital footprint can significantly affect your reputation.
“You want to guard your online reputation,” Siddel says. “Be professional at all times.” ❖
Social media tips
LinkedIn is the preferred app for professional development. “It’s a way of sending out a business card,” says Keith Siddel, PhDc, JD, MBA, CHC, an attorney and healthcare finance and compliance expert based in Monterey, California.
Here are tips for getting the most from your LinkedIn account.
• Have a profile photo.
• Personalize your connection requests.
• Keep communications positive and professional.
• Turn off notifications when updating your profile.
• Regularly nurture relationships.
• Make your contact list open to your connections.
• Offer to introduce your connections to others in your network.
• Respond promptly to messages (1 to 2 days).
• Post no more than once a day to avoid overposting.
Some tools (basic service is free) can facilitate the use of Twitter and other social media platforms.
• Hootsuite: A dashboard for managing your social media “feeds” such as Twitter, Facebook, and Google Plus.
• Little Pork Chop: Automatically “chops” your longer messages into a stream of tweets.
• Storify: Allows you to collect and share postings from different social media platforms as a “story.”
• Tweepi: Helps you manage your Twitter account by providing statistical information; for example, one feature creates a list of users you follow, but they do not follow you in return.
Siddel recommends regularly checking the privacy settings on apps because sometimes companies change them without notifying users.
Cynthia Saver, MS, RN, is president of CLS Development, Inc., Columbia, Maryland, which provides editorial services to healthcare publications.
ReferencesAMN Healthcare. 2013 Survey of Social Media and Mobile Usage by Healthcare Professionals. http://www.amnhealthcare.com/industry-research/2147484460/1033/.Papadakos P J. The rise of electronic distraction in health care is addiction to devices contributing. J Anesth Clin Res. 2013;4:3.Read Less