Patient's Families as Facebook Friends....

Hi -
Sorry if this has been covered at length, I did a search and it seemed the posts were more related to med-surg and as we all know, unlike med-surg we may spend months and months with the same family as they process the crisis that the NICU represents to them. At 2 am it is easy to chat about their work, your kids, plans for vacations etc. It helps establish the relationship and passes the time. Can the families and nurses understand the line between that and "real" friendship? What I am wondering about is... when these families friend-request you on facebook.... how is that handled? In my unit there are nurses who have families of CURRENT patients as friends, many many more who have families as friends after discharge. Some visit the babies in their homes or even baby sit and post pictures of them as they grow. And we have all probably seen the "went home to hug my own kids" post by our peers.... and it usually means something went bad at work. I wonder about the effects of these kinds of posts on the families. And at what point is there risk of HIPPA violations?

So... I have a few of questions....
1- Does your hospital have a policy on friending patients / former patients on facebook?
2- Do you personally friend?.... is it usually before or after d/c?.... why or why not?
3- Can you think of any alternative ways for nurses and families to keep up with one another without friending them? (like does your NICU have a family facebook page? -- or some other online resource for maintaining contact?)

Thanks for any feedback.... I LOVE facebook and some of my peers think I'm crazy for (almost never) adding patient's families! ~~ spacey

1. No policy. We have a social networking policy, but it doesn't include that.
2. NO NEVER. I know a lot of the staff dothough even when the baby is still in the hospital. I'll give my email to a primary's parents and they can update me if they want but no phone number, no FB, no babysitting.
3. I actually ran a page for my unit on FB but then the social networking policy came out and anything affiliated with the hospital must go through PR or HR or something and be run by them. So I just deleted it because it's not worth losing my job over or getting in trouble.

I think having current patients is not right. Esp if you inadvertently post something about the workplace that is bad...and that parent sees it, prints the page and takes it to your management. We had this happen. Not pretty and the person lost their job because of it (we have a social networking policy also...can't say bad things about where you work!). And you shouldn't be friending parents on there either...don't send requests and explain to them that you don't mix work and your homelife. You have to remember that when you friend someone on there, they can see what your friends post too unless they have it so that only friends can read and respond to their posts. That could get awkward for your co-workers.

When a family wants to stay in touch, I tell them to send things to the hospital for me or to my work email. I don't give out personal info, that is crossing the line. My job is my job, my homelife is my homelife. I don't cross that. I don't go to baby showers, birthdays, etc.

I don't friend patient's families on facebook. My work doesn't have a specific policy on it either. I just don't feel comfortable with it and don't want to risk my job over it. I know some coworkers who have given parents their phone-numbers to keep in contact, and they get called about medical advice and even baby-sitting requests. I do not want to cross my professional boundaries with them. I have never given families my personal contact info. Some families have shared their website blog information and I have kept in touch that way without risking my own personal info.

We don't have a policy that covers that specifically, although we do have one for social networking.

We do get to know and care for our babies and their families well during their stay and I can certainly see the desire to stay in touch, but I don't friend families ever. I don't give out my phone number or my email address, either. I figure if someone needs to get in touch with me they can go through the hospital.

You just never know and I'm not a fan of blurred boundaries . It seems a bit risky legally to babysit discharged patients, although I know several nurses who do it. I do follow blogs of families when given the address and that satisfies my need for follow up .

I don't think we have a "social networking" policy; but I can certainly see it coming in the future. I am curious to know what is generally included in the policies of those who do have them. I haven't "friended" or asked to be "friended", fortunately. Also, I have currently deleted my account. I know some co-workers make vague comments about work on FB, which makes me very uncomfortable. I don't give out my phone# to parents, I don't babysit or even go to BD invites or to their homes at all. I just like to keep it separate between personal stuff and work. I have on rare occasions given them my email address to a couple of very special parents, although I don't think that is really such a good idea, I haven't had any problems with it, just know it is a potential. I see former patients and families at our annual NICU reunion, view their (to the) unit xmas cards and pictures, or the occasional visit back to the hospital unit to say hi. I love seeing them. I just feel that my energy should remain with those I'm caring for now, not spread out among former patients and families. I also think it is important for me and for them to have a completion of cargiving at discharge; they need to become independent of us, and we need to move on. I've had families send things to me in care of the hospital, and I appreciate it and try to respond appropriately.

Add me to the don't do it team. Bad stuff.

We just had a huge mandatory inservice about professional boundaries. You are crossing those boundaries when you friend them on facebook. They did include babysitting kids we have cared for because you are held to a higher standard than Grandma. You are crossing them if you give them your phone number, you are crossing it if you go to a baby shower or birthday. In most hospital standards manuals, you will find something that addresses this.

Also, keep in mind that a family has 18 years to sue. What may seem fine now can be not so fine in a few years. We had one family that decided to bring suit after 4 years when the kid started having more and more neuro problems. The first thing legal asked of the people who were deposed was if they had any contact with the family, even thru social networking.

Moral of the story...our job is our job, don't cross those professional boundaries. Keep in touch thru blogs, etc. but facebook and myspace are bad.

I don't know what my facilities policy is on the matter, but I won't do it. I'm leery about friending co-workers on FB even, and extremely selective about the ones that I do. There is just too much room for trouble, you don't actually know these people, and some people are very easily offended.

Thanks for the replies so far.... and overwhelmingly in favor of keeping work life and personal life separate. Now I feel like less of an oddity. We have soooo many people doing this....probably 90% of our staff.

Another similar situation, giving out cell phone numbers. We had a nurse who had parents texting with her during the shift about their baby and how the shift was going... and their baby wasn't even her patient! Yet they didn't call and speak to the nurse assigned to their baby. It seems crazy and I feel like I'm the only one who has a problem with it.

NICU Gal - Was the professional boundaries inservice done "in house" or was it like a program the hospital brought in... like a conference or special speaker? I really would like to see something like that happen at our hospital. How was it received? People are very very possessive of their "special relationships" with the families..... It's going to be a tough battle.

thanks for the input... please post more!

It was actually given by our legal department and HR. It was pretty eye opening!

I'm not afraid to speak up and say I have a family that I am close with and have become "friends" with since discharge. I feel I am smart about it and not crossing any professional boundaries. I have never babysat but I have visited them at their home once and have gone out to lunch twice. I am friends on fb but I also rarely use fb. That being said, that is a unique circumstance and I would not make it a habit

Thanks for the replies so far.... and overwhelmingly in favor of keeping work life and personal life separate. Now I feel like less of an oddity. We have soooo many people doing this....probably 90% of our staff.

Another similar situation, giving out cell phone numbers. We had a nurse who had parents texting with her during the shift about their baby and how the shift was going... and their baby wasn't even her patient! Yet they didn't call and speak to the nurse assigned to their baby. It seems crazy and I feel like I'm the only one who has a problem with it.

...People are very very possessive of their "special relationships" with the families..... It's going to be a tough battle.

thanks for the input... please post more!

I would say about 40% of our staff are friends are with current patients, probably close to 60% are friends with previous patients and families. I do have a problem with it. I won't do it. I have four former patient families that are friends with me on FB, we didn't become "friends" until 1-4 years later. This is out of about 550 friends. I have denied many friend requests as well. I do not baby-sit, I have gone to one birthday party. Work is work, personal life should be personal life.

Many of my co-workers will babysit or go to birthday parties, it makes me very uncomfortable.

Also, we have a couple of RN's who take pics of babies and text them to the parents or text moms about how the baby is doing that day. Again, makes me VERY uncomfortable. Lines are blurred and crossed and then what happens if the unthinkable (death) takes place with that child?

I **NEVER** give a family my personal contact information. One mom was texting one "primary" nurse and complaining about another, then after discharge she was texting questions to the nurses. Not good.

My mother was a nurse and she taught me that there are distinct lines and boundaries and life is so much simpler when those are not crossed. She was right.

OMG, I would never take a picture of a patient with my phone, that is a big humongous HIPPA violation.

We just had 2 people out on a 10 day no pay suspension for texting parents and sending pics...the parents put it on Facebook and it filtered back to management. HR told them that this was their warning. We have a very specific policy regarding crossing lines and social media. Remember, no matter how private you think things are, they are not. And on two cases Inwas deposed on I was asked in both of them if I kept touch with these families in person or by social media. No, no, no.

When we were inserviced by legal it was not well received, and people continued and two were caught. People just don't learn and feel it is their right to do whatever they want. Go ahead, you are only hurting yourself. When I see someone has friended a parent I block the parent and defriend that person.

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