Thursday, June 21, 2007

Nurses Blogging Detailed Stories, And Some Ethical Questions

If you have not worked in the medical field and want some inside information you may want to spend some time reading the blogs of nurses.

I feel that in general many laypeople don't know what the health care system is really like until they are either the patient or the family of a patient. I think that all Americans should have a better understanding of our health care system especially if they are going to criticize the system itself or the health insurance system. I also wished that more laypeople had a true interest in their own health and well-being not just only hearing of medical things on some medical television drama and having their exposure tied in only to personal entertainment. Trust me, everyone would be better off if they were more informed about the working of the human body, nutrition, maintaining wellness, and then about the in's and out's of seeking health care through typical western medicine or alternative medicine routes.

It is eye-opening to read these real-life stories that nurses are sharing on the Internet. This is a great example of one area in which the blogosphere is changing who can communicate to the masses, for free, and what content readers can access quickly and easily. Think about it, before this, we may only have been able to read medical stories like these if we read a biography of a doctor or a nurse (unless we have friends and relatives who work in the field).

Since I've worked in the medical field and have relatives and friends that still do, I already hear some of these stories first hand. I have seen some things first-hand. Some stories you can't even believe unless you've seen them, you'd think they were fiction otherwise.

One of my blog readers pointed me to ER Nursey - Stories From An Emergency Room Nurse who tells detailed stories of some of her patients or the ER or hospital issues in general. (The blog entry that I was pointed to and which was the impetus for me writing about this topic was this blog entry which involves a judgement of a minor aged patient's mother which led the nurse to report them to DCF. Perhaps knowing what caused me to think about this issue for over a week before blogging my thoughts might help you realize what inspired me to blog on this topic). If you check her sidebar there are lots of other nurses' blogs there to read.

Reading the blogs of these nurses may help a layperson learn more about what types of situations come through an ER and the hospital.

One criticism I have is that sometimes snap judgments are made based on a small amount of information as is presented by the patients in the ER or based on their physical appearance, what they are wearing or if they have a cell phone, etc. Speaking for myself my life is quite complicated and thinking about what an ER nurse might have thought of me or my grandmother from the little time we spent with the nurse and other staff in last month's trip to the ER is a bit unsettling and could easily lead to false judgments. The most important issue is that often in the ER and the hospital also the staff are busy and some don't even let you finish a full sentence when answering the question THEY asked. I guess the judgment and these perceptions work both ways, as a patient may feel they are not being given enough medical attention while in the hospital and the nurse may make some other negative judgments about the patient and their family. In general, this is good to remember about why passing judgment is not a good thing. I constantly tell myself to not judge others based on what I see as I don't ever know the full story or situation.

A few other thoughts on this are:

Is it ethical to share recent stories that were part of what is supposed to be confidential medical care?

I would say that telling old stories or talking about things in a more general manner with vague examples is more ethical. (An example from my own blogging is that if I had something negative to say about my nephew about something that happened today at a family holiday celebration I'd not tell all the details or even tell it today, but at some later time I may discuss that something I am not in favor of is eight year old's using profanity, ever, and especially using it to call names to one's own parents to their face is wrong, and I'd never say that it actually happened with my nephew.)

What would current educators of nurses have to say about the ethical issues of blogging about nursing IF the blog posts contain current, recent stories of patient care? Would they say that blogging personal stories of patients is ethical?

Do employers not care that their employees are telling stories like these? When I read the book "The Weblog Handbook" by Rebecca Blood, she strongly advised to not blog about issues at work saying that some have not only lost their jobs but have been sued by their former employers. She also said that potential future employers may some day read the old blog of a job candidate and may make their decisions to not hire a person based on the blog's content.

This is some more stuff to think about.

Note: I expanded this entry on 6/26/07 to explain more about why I blogged about this topic since now this blog entry is being linked to by at least one nurse-blogger.

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TC said...

You raise good points. First, as an ex-ER nurse, I know the burn out rate is high and cynacism is rampant. But most ER nurses and doctors I've met render great care as a matter of pride. But that's still no excuse for being prejudiced. I am working on an article on this very topic for (they have a blog, called NJO blog. I write a column every Tues on nursing ethics.

As a nurse blogger, I take great pains to make sure I omit recognizable details, or make a composite out of several patients, etc. Many nurse bloggers I know do this, some state that they do this, some don't. If someone is putting private info up-names, dates, identifying characteristics-they would be in a HIPAA violation. I do think having a forum is valuable if it's done appropriately.

And of course, if you're using the web to get medical insight or advice, a BIG grain of salt and common sense should be used. I have received some great advice and seen some real ignoramuses.

Kim said...

Great post.

I can tell you that after 29 years, myriad facilities and four specialties, every single story on my blog is a big ol' composite of everyone and everything. Sometimes embellished to make a point! LOL!

Most nurses write this way - it looks like a "real" story from a recent visit, but in reality it is probably made up or a composite of lots of experiences.

I don't blog straight up about any one patient. Oh, and my work knows I blog and my coworkers read it!

oncRN said...

I agree with Kim. They may sound like it just happened yesterday, but my posts are born out of years of patient experineces that one day form themsleves into an anecdote.

AtYourCervix said...

Fantastic post! I always change details when I post about a specific patient, or I will make a "composite" patient.

What struck me right away about your post was the term "having their exposure tied in only to personal entertainment." WAY too many times, have I seen this with my patients and their extended families. It's about the drama and the entertainment. I mean, come on, birth is NOT A SPECTATOR SPORT!

::::end of rant:::

Once I get my side bar updated, I'm adding you (hope you don't mind!)

Working Girl said...

You bring up important issues in this post. I am a nurse blogger who tells patient stories. However, the stories I tell are always, always, always altered in some way from the truth. They are composites, or identifying details have been altered. I state that I do this in my sidebar and refer to it in the title of my blog: Mostly True Stories. I also am generally making fun of myself rather than my patients. There are also stories that I would love to tell, but I just can't because patient-identifying details are so important to the heart of the story...Also, like Kim, my work knows that I blog and many of my coworkers read me.

Again, this was an important post!