Not only would such actions almost certainly be in violation of a facility’s policies but, depending on the nature of the incident, could be in violation of HIPAA and other federal and/or state laws.
Disciplinary actions can range anywhere from termination to suspended licensure to criminal charges and possibly jail time. Some cases have even been investigated by the FBI for HIPAA violations, and in the cases of explicit or indecent images, referred to the Sex Crime Unit.
After pleading guilty to voyeurism, Waller spent three days in jail, followed by probation. Brown was arrested and subsequently charged with willful violation of health laws.
Protecting your residents: Developing and monitoring a policy
Many facilities already have social media and cell phone policies in place, and administrators of those that don’t might assume that they don’t need to spell it out. After all, it seems like it would be common knowledge that taking and sharing images of residents is a serious violation of privacy and ethics.
Still, it’s important that the facility have an official policy written up and shared with the employees, even posted in visible locations as necessary. This serves to reinforce the policy and acts as a constant reminder of its importance. More importantly, it can serve as a guideline for staff members who might witness something improper but not know the proper protocol for reporting it.
It’s crucial to be proactive, even if your facility hasn’t yet experienced any such breaches. Here are some guidelines that facility leaders should consider when developing their policies.
What administrators can do:
1. Social media privacy training
Social media is a fairly recent phenomenon, and many organizations are still grappling with what it means to train their employees in proper social media use. Because social media is generally a casual instrument of communication, some users post without giving it a second thought, especially with apps like Snapchat where the images aren’t posted publicly.
Waller told ProPublica, “Everybody takes pictures of the residents all the time. I’m not the only one.”
It’s imperative that the point be made strongly and clearly that this is unacceptable behavior. Provide in-depth training on privacy, confidentiality, ethics, and HIPAA regulations.
2. Monitor the policy, but know the law
On public platforms like Facebook and Twitter, it’s fairly simple to keep an eye on what people are posting. However, you have to be careful not to violate an employee’s rights. It goes without saying that posting degrading images of residents crosses a line, but other posts, such as written gripes about work, could potentially be protected by the National Labor Relations Board. If you want to be certain, have a lawyer read over the policy before making it official.
3. Pull from your other policies and outside regulations
If your facility doesn’t already have a specific social media policy, you likely have confidentiality policies in place that you can use as a foundation. You can also pull from HIPAA, as well as other federal and state laws, to underscore the importance of maintaining these regulations. Be as specific as possible in outlining what constitutes a violation.
4. Address platforms and overarching policies
The scope of social media is constantly shifting and being updated. New platforms are introduced all the time, while other platforms become outdated and fall into disuse. Address guidelines specific to popular platforms, but also develop an umbrella policy to capture any upcoming changes in the social media landscape. On that note, be vigilant about keeping your policy current. A good rule of thumb is to review your policy every six months to ensure it’s up to date.
5. Be consistent
Once you have a specific policy in place, it’s important that you remain consistent in its application. Although instances will inevitably be dealt with on a case-by-case basis, administrators should stick to the rules outlined in their policies to ensure that staff members take it seriously and that all issues are dealt with using proper protocols.
What staff members can do:
1. Bring ideas up to administration
If your facility doesn’t already have a policy in place, or the policy lacks elements crucial to making it truly effective, be the catalyst to make sure your residents are protected. If you see holes in the policy, bring them up with your administrator. If there’s no policy at all, bring up some ideas on how to develop one.
2. Familiarize yourself with policy and regulation
If you don’t know whether your facility already has a policy, or what the details are, find out. But perhaps even more importantly, make sure you’re aware of state and federal regulations that dictate was is and isn’t acceptable social media behavior. Also, find out if your BON has specific policies. A 2012 NCSBN survey of BONs showed 17% have specific social media guidelines in place. When you know the rules, you’ll have a much easier time helping to maintain them.
3. Err on the side of caution
If you’re uncertain about whether to share a certain social media post, safe is better than sorry. After all, no social media post is worth risking your career over. Ask yourself, “Does this post violate any laws or regulations? Even if it doesn’t, is it a breach of ethics? Is it potentially embarrassing to my resident? If someone else shared this about my loved one or me, would I be okay with it?” If you’re uncertain, ask your administrator.
4. Report what you see
As a nurse, it’s part of your job description to make sure your residents are safe, protected, and cared for. Part of that responsibility is protecting them from unacceptable treatment they may be receiving from your colleagues. Not only that, but you may be held accountable if you’re aware of abusive behavior and don’t report it. Complaints to BONs have included not only direct actions resulting in breaches of privacy, but also failures to report others’ violations. Be an advocate for your residents. Report to your administrator any abuse, breach of privacy, or violation that you witness.
By taking these steps, you’re helping to preserve your residents’ dignity and allowing your facility to be the safe haven it’s meant to be.