Hospice and palliative care organizations must pay attention to their image and reputation when engaging readers and followers on social media sites. Being associated with other reputable organizations and individuals is paramount to ensuring success. When engaging staff and other people on social sites, hospice & palliative care organizations must ensure the content, posts and comments meet an expected standard. Learning the hard way, can be a challenging and embarrassing lesson when it comes to media sites and content. Here are examples of bloopers and mis-steps that have happened online:
What happens online....stays online:
If you post something online, it's indelible forever. If the content is engaging and amusing, it will be shared far and wide! Sometimes the wrong stories, video's and pictures go viral for the wrong reasons. Having a screening, editing and approval process within your organization can help. People have been known to:
- Post their personal issues on their professional profiles
- Make derogatory remarks online that damages their online profile
- Make remarks that were interpreted incorrectly and / or
- Have skeletons in the closet that inadvertently became public knowledge.
Case in point.....
During your college days....years ago, you and your buddies posted explicit statements and pictures on your facebook page one night. A human resources staff member happened to do a google search one day and there you were re-exposed again. If it hasn't happened to you, you know someone who it happened to or you know someone who is at risk. College students are notorious.
Rules of Engagement:
Healthcare organizations have the added burden of ensuring patient confidentiality. Posting names, pictures, medical information and identifiers that can be associated with a patient without their consent or knowledge violates HIPAA rules. If hospice staff are posting on your / their social media pages a constant reminder is necessary regarding the rules of engagement. People have been known to:
- Post pictures of themselves with a patient on their facebook page which include the patient's name, diagnosis and thoughts about the patient's health status.
- Post a reply on a patient's blog page which was unsolicited and details their health information.
- Provide patient contact information to unauthorized people online
Case in point.....
- A woman in Ohio who had a surgical procedure sued her surgeon for publishing before and after photographs without her consent.
- An EMS worker was fired for taking pictures of a naked trauma victim and posting these pictures on their facebook page.
- A Los Angeles hospital banned the use of cell phones and laptops by employees after numerous photographs were discovered on employee social networking pages
Inappropriate Shenanigans
Have you ever posted or tweeted while under the influence of happy hour beverages! People tend to be impulsive and un-inhibited when under the influence. Comments are posted, cellphones get sequestered and suddenly someone has posted a comment on your social media site that is completely inappropriate. All PDA's, laptops and electronic devices should be password protected without exception when patient information is contained within and when your professional and personal reputation hang in the balance. Just like the statement "Friends should not let friends drive drunk".......friends should not let friends post on social media sites during happy hour. For those of you with a propensity for inappropriate spontaneity....a downloadable solution exists at http://socialmediasobrietytest.com/ Personal branding is an important professional activity not to be taken lightly.
Case in point......
A Missouri Congresswoman's facebook account apparently was hacked and a status update was posted which read: "I love lobbyists! All the free food and stuff you get. This job is awesome!"
What you say can be held against you
Have you seen defamatory comments about organizations and individuals online? Apparently, in a litigious society, the risk of being sued is significant. Any negative comments about any subject matter are best avoided on all social media sites representing any professional organization. Hospice & Palliative Care organizations are well served to distribute their policy about social media site use by employees and make policies known to patients, families and vendors. Prevention and developing a rapid response strategy to managing negative social media events should be part of the policy development.
Case in point......
- A Chicago company sued a tenent for her defamatory tweet about a moldy apartment which cost her $50,000 due to the actual or perceived damage to the realty company's good name.
- A $25,000 fine was suffered by the Dallas Mavericks owner for badmouthing the referees online after a team loss.
Social media monitoring is a necessary activity to screen for negative or inappropriate comments, remove posts that are deemed inappropriate and to police professional sites. While many organizations are cautious about social media use, they continue to expand and organizational presence is a must. Social media management companies offer the types of "listening" tools to offer monitoring and proactive management of postings online. This helps significantly to ensure appropriate and reputable posts so organizations never have to learn the hard and embarrassing way.
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When someone raises their eyebrow, this is a sign that they are not feeling threatened. When you raise your eyebrow, it often elicits a smile from the person your are interacting with, so the next time you receive an eyebrow raise....you know you have a good rapport with this person and they are comfortable with you. Why not try to foster a positive response from your patient by raising your eyebrows next time you talk to them? Maybe you will notice that they warm up to you easily!
A person's eyes dilate strongly when they are stimulated by the conversation and are in a problem solving mode. You may use this to your advantage when you are discussing goals of care and the course of treatment. Paying attention to whether patients and family members have dilated pupils can give you a clue as to whether it is the right time to address important planning issues. When the pupils are dilated, chances are that decisions made will be positive ones.
The first person to look away in an introduction is the more submissive. This can be helpful to understand family dynamics, who the decision makers are, and who is most likely to be leading the family discussions. It can be helpful to determine the hierarchy within a family and whether the people you are dealing with are in a dominant role. They may wish to dominate you in the relationship, which may make the relationship difficult and may be something that you must pay attention to.
If a person's eyes are moving around and darting from one object to another, they are either nervous or bored. The type of interaction you are having with them will tell you which is true. If you have engaged them in conversation for an extended period of time, you can make an assumption that the conversation is now boring for them. If the conversation is about a difficult subject matter, chances are, they are nervous. You might want to try to reassure them and comfort them if it is a necessary discussion. 
A clue about whether someone is being open and honest is whether they are showing their palms. If palms are displayed, they are telling you the truth. If you talk with your palms facing upwards, it forces others to speak truthfully too! Try it!
The internet has changed everything that we do both professionally and personally. With the emergence of social media sites such as Facebook, Twitter, Linked In, and MySpace opportunities have been created to engage different social groups and individuals who are looking for information about end of life care. Our attention is being constantly drawn to forums, emails, webinars and videos online for useful information to guide us.
About Practitioner Solutions: Practitioner Solutions is a hospice consulting company led by Niamh van Meines a graduate of Columbia University's Nurse Practitioner Program. Practitioner Solutions is committed to helping clinicians, practitioners and organizations in achieving a specialist level of end of life care using innovative solutions.