Wednesday, December 17, 2014

Social Media in Nursing Management



                                                                                                                         

The Use of Social Media in Hiring and Firing of Nursing
Gena M. McMahon












Introduction
Since the rise of technology has greatly influenced our society in recent years, this brought about a new era where social media has dominated our culture in the United States. For this reason, corporate America has tried to take advantage of the fact that in 2014 74% of internet users worldwide use social media (Pew Research Center, 2014). In the eyes of an employer, social media sites are perfect matchmakers to pre-screen applicants for jobs based on information that is made publicly available. Since health care administration makes decisions by balancing cost effectiveness and efficiency with quality patient care, social media is used to make pre-judgments about applicants to save time and money. This is currently an ethical dilemma for a plethora of reasons including the fact that assumptions are being made about applicants before a scheduled interview. Also, applications may be discarded base on an employer’s personal bias based on information provided by social media that should be protected under law.
Social media is also a great bank of evidence when the health care team is dealing with a claim involving HIPPA violations and quality control. Even if a comment or photo is deleted, the piece of information is still archived and can be retrieved in the future. This is important when dealing with a nurse’s lack of integrity or professionalism when evidence is a critical piece of information to verify an event. However, the use of social media in the firing process can be an ethical warzone because administration can use it to fire someone as retaliation for something a subordinate said on a website. This is yet another situation which is supposed to be prevented via legal employee rights. However, without strict regulation, employers are still making these decisions.

Pros of Hiring
            Employers are constantly making decisions based on what is best for the company. For this reason, they are on a mission to find the most competent workers for the job at hand because each employee is a unique ambassador who is a portion of the company image. Supervisors tend to look for traits in applicants that reflect a company motto, slogan, or promise. When using social media, personality traits based on photos, posts, or even a quick biography can help employers sync applicants to the preferred traits and personality that would best reflect the company and its image. As a result, this can lead to a more productive and economical employment process that saves time and money for the company who can conducted fewer, more focused interviews.
Cons of Hiring
Using social media to screen during the hiring process is an ethical dilemma that can result in legal consequences if an employer does not do it correctly. Using information off of social media sites that was thought to be confidential information is a violation of privacy and much of this information can be given from photos and biographies. In some cases, the applicant may have assumed that information was concealed on a site and faulty privacy settings may have reset to display that information without consent of the user. Social media can give away information that the EEOC states is legally protected under the Civil Rights Act of 1964 such as age, race, sex, religion (U.S. EEOC, 2009, pp 1-9). For this reason, an employer’s veracity may be questioned when screening applicants with social media (Cherry & Jacob, 2014, p 175). 
Pros of Firing
One of the main perks of social media use in firing of nurses is that it is a way to strictly enforce HIPPA violations based on solid evidence linked with the notorious ‘electronic fingerprint’. Any electronic trace of information that can directly identify a patient (ex. name, photo, room number, and situation) is a clear violation that needs to be resolved (Knudson, 2012, p 6). Through the use of social media, the correct legal ramifications can be imposed in order to build a safer healthcare system with the most competent workers who protect a patient’s right to privacy.
Cons of Firing
            One of the issues is that there is no clear-cut regulation of penalizing employers for firing a subordinate as a form of retaliation for bashing the company and/or superiors. For this reason, there is a clear violation of justice. (Section 7 and 8 of the National Labor Relations Act clearly protect the rights and voice of an employee which can quickly be stripped away in a social media policy (Bagley, DiGiacinto, & Hargraves, 2014, pp 379-380). It can easily be overlooked upon signing a binding contract upon employment underneath a lengthy employee handbook and current legislation is not clear or universal enough as to how employers handle social media policy.
Analysis of Impact on Health System
            The use of social media is highly economical because of its impact on how quickly employment decisions can be made. If necessary, it can confirm or invalidate HIPPA violations and claims of professional misconduct to improve patient safety and quality of care as health care systems (Cherry, 2014, p154). Administrators can swiftly hire trustworthy, competent nurses and are willing to discipline or fire those who do not follow company protocol. In a health care setting, these claims not only reflect direct violation of federal law, but institutional policy defined in the employee handbook upon employment (Bagley, DiGiacinto, & Hargraves, 2014, pp 380-381). For this reason, it can also promote a more ethically sound workforce that portrays justice, veracity, and beneficence (Cherry, 2014, p 175). Monitoring social media can be used to promote patient privacy and ensure restitution for a patient in the event of a violation in order to promote quality health care.
            Employers can also promote quality health care by using it to screen applicants for traits that depict a personality that would suit the health care system and positively reflect company image and policy. Pre-screening applicants is faster, cheaper, and more efficient than scheduling larger amounts of interviews and researching a greater number of applicants. Employers can make assumptions based on pictures that depict leadership qualities, an applicant’s appeared influence on peers, and lifestyle. However, this can become skewed by an administrator’s personal bias which can lead to the denial of a perfectly competent applicant (Ferguson, 2013, p 746). Such dilemmas may involve color, gender, age, and religion; all of which employers can never legally ask during an interview but can easily obtain via social media. For this reason, consumers may be affected by a steadily declining group of diverse nurses which can greatly impact the quality of patient care and patient-caregiver relationship.
Opinion
            In my opinion as a nurse, I believe that the use of social media for pre-screening applicants is beneficial because it is something that can be compared to pertinent information retrieved at a job interview in order to verify accuracy and veracity of the applicant. Pre-screening with social media can also depict a person’s life style via posts, pictures, and comments. Red flags that may go unnoticed during an interview can be detected on a person’s webpage because people are not always on their ‘best behavior’ on the internet like they are at a one-on-one meeting. I believe social media can easily reflect a person’s image and nurses typically trust their superiors to know what is best for the company. For this reason, since both the administration and faculty mutually benefit from competent workers, nurses trust that supervisors know their health care team well enough to pick out the best matches that will contribute to the quality of the health care team.
            Quality nurses know that they are held up to a certain standard in society and in their practice and use good judgment. For this reason, it is logically implied that the majority of nurses believe quality nurses have good judgment as to what they post on social media. As a result, they would likely question a nurse’s competency if a clear violation of HIPPA or professional misconduct were to arise on social media.
            In my own personal opinion, I believe that social media should not be used to hire or fire somebody yet until the use is strictly and universally regulated by federal law because of the ethical and legal dilemmas involved. The First Amendment gives a person right to free speech can be stripped with a vague social media policy in the fine print of a hefty employee handbook. Or, it can illegally be taken away or direct violation of the NLRB Act. This act was created by the National Labor Relations Board in order to protect both union and non-union workers from getting fired due to employer retaliation after criticizing superiors and/or the company itself (Bergeson, 2011, p 46).
            Employers can easily violate the NLRB Act because is it not strictly regulated and most administrators will not pay legal consequences for taking advantage of this. In addition, many employees are not familiar with this act and likely don’t even know it exists. Without being armed with the proper knowledge, they are unaware that they have the right to file a claim under the Equal Employment Opportunity Commission to seek justice and regain their job back if requested. After universal social media policies have made and laws have been enforced, then I personally will approve of the use of social media in the hiring and firing of nurses.
Conclusion
            Social media is a cheap, effective, yet economical way to control the quality of service in the healthcare system. However, both employers and employees should arm themselves of knowledge regarding legality and the rights of each party and be prepared to face the potential legal consequences (good and bad) of their actions. Employers should be forewarned that claims may be filed against them under the EEOC for wrongfully researching private information protected under the Civil Rights Act of 1964 or firing under retaliation (NLRB Act). Employees and applicants should also be forewarned that they can be taken advantage of in this manner if they are unaware of their rights and are strongly encouraged to gain perspective of their own rights. From the perspective of a nurse, I believe that the use of social media in the hiring and firing of nursing is beneficial to maintenance of a superior healthcare team and long as administrators have no outrageous bias and follow all EEOC guidelines. However, in my own opinion, I feel that the EEOC needs to enforce strict regulation on its policies and implement a universal social media policy.









References
Bagley, J.E., DiGiacinto, D.D., Hargraves, K. (2014). Radiologic technology, 85(4), pp 377-389.
Bednar, J. (2013). Social media poses a legal minefield for employers. Businesswest, 30 (14), p 24.
Bergeson, P. (2011). How social networking sites affect you employment-interface with Facebook and other social media sites may have legal consequences. The Journal of Physician Assistant Education, 22(1), p 46.
Cherry, B., Jacob, S. (2014). Contemporary nursing-issues, trends, and management. Mahlmeister, L.R., Legal issues in nursing and health care (p 126,154). St. Louis, MO: Elsevier, Inc.
Cherry, B., Jacob, S. (2014). Contemporary nursing-issues, trends, and management. In Sanderson, C., Ethical and bioethical issues in nursing and health care (pp166-182). St. Louis, MO: Elsevier, Inc.
Ferguson, C. (2013).  “It’s time for the nursing profession to leverage social media. Journal of Advanced Nursing, 69(4), p 746. 
Pew Research Center. (2014). Social networking fact sheet.

U.S. Equal Employment Opportunity Commission. (2009). Federal equal employment opportunity laws.

Hydrotherapy and PTSD

Water is the basic unit of life that no human can deny; the purest form of life sustaining power composed of oxygen and hydrogen. It is a biological necessity that keeps each one of us alive. The miracle of water is that it is constantly recycled on a chemical level; a cheap universal resource that the majority of people have access to worldwide. Consider water for its healing properties-it obviously cleans physical wounds and reduces risks of infection in them, but the cryptic benefit of water is that it can help heal mental illness in Post-Traumatic Stress Disorder (PTSD) and help its victims cope with the struggles of everyday life. Hydrotherapy is the use of water in a solid (ice), liquid (water), or gas (steam) in a therapeutic manor. Many people who suffer from PTSD do not find relief in medication and even many forms of complementary/alternative therapies. However, some research supports the use of hydrotherapy in patients suffering from PTSD to combat chronic pain, promote circulation, induce meditation and relaxation, and prevent or interrupt bouts of dissociation.
Hydrotherapy is a suitable option for soldiers and survivors of abuse because this is a demographic of people that do not have a lot of resources or money. Fortunately, water is a resource that everyone has access to; it is a basic principle of human survival. More so, water is very cheap (if not free) and easy to manipulate to customize a therapy plan. Temperature preferences, aromatic oils and salts, and amount of water all have an impact on the effectiveness of treatment and vary from person to person.
Balneotherapy is a type of hydrotherapy where water therapy is used in conjunction with aromatherapy and bath salts. Bath salts are aromatic; producing pleasant scents to calm or stimulate the neurosensory pathways in the body. Bath salts containing lavender, jasmine, chamomile, and vanilla are commonly used in PTSD therapy for their relaxing qualities. Hydrostatic pressure from the water is successful at reducing pain and edema, while at the same time pores in the skin are open to diffuse minerals across the skin barrier into the body. Hot water is more effective at improving circulation and hemodilution while cold water helps to  suppress pain and improve muscle tone. (Kron)  A group of Hungarian researchers conducted a single-blind study concerning balneotherapy on a group of 60 patients with low back pain, half of which bathed in mineral water and half bathed in tap water. The 30 patients that bathed in mineral water found a significant improvement in their back pain for at least 3 months after the treatment ended. (Balogh, 2005). For this reason, balneotherapy (the use of minerals in water) is highly recommended to patients with chronic pain like those who suffer from PTSD.
Post-Traumatic Stress Disorder tends to sprout from traumatic events like military combat and abuse, though not everyone who experiences this gets the disorder. However, for those that do, life can be stressful to say the least. One major yet stressor of victims are flashbacks: events caused by a trigger that psychologically forces the victim to relive the traumatic situation. In the event of a flashback, a person may feel numb, disoriented, delirious, and struggle to stay in present time. The use of hydrotherapy is useful for producing sensory nervous responses that allows the person to focus on the physical qualities of the water to stay in touch with reality rather than succumb to the ensnarling thoughts of the mind.
Another ensnarling thought of the mind is anxiety; a main component of PTSD. Hydrotherapy can be combined with meditation and mental imagery to suppress and eliminate racing thoughts which potentially domino into panic attacks. Panic attacks are very real and have physical implications on the body from psychogenic pain to symptoms of a heart attack. Though medications can often rid people of anxiety and prevent panic attacks, they have side effects that often outweigh the benefits of use. For example, extreme dizziness, weight change, drug interactions with other medications, and fatigue are common side effects associated with the use of anti-depressants and anti-anxiety medication. To no surprise, water has no side effects of use and therefore can be complemented by any medication, so there is no fear of a bad reaction. On a similar note, there is no magic pill that can cure or treat PTSD, so there is no large benefit of using psychological drugs that have a small probability of fixing the problem.
(OIF Abigail, 2013) “Anger and aggression are associated with post-combat problems among military veterans…anger is an emotional manifestation marked by hostile impulses and the perception of blocked goal, which includes particular cognitive, physiological, motivational, and behavioral components”. Anger is a large component of PTSD for anyone who has the disorder and has been in a traumatic physical confrontation. Hydrotherapy is a prime way to channel out the anger and “cool off” or relax. Water has physical properties that cushion a blunt force and make it easy to safely punch it without causing damage to the victim or others. Other properties of this fluid that make it a suitable outlet for hostile aggression include: the absence of feelings, inanimate properties, unable to communicate with the victim. Just as the victim may have felt at one point, the water will not act out against the aggressor (victim) or talk back to it as the victim may have done in a previous time. This remarkable idea has the potential to influence the complete destruction of the cycle of abuse in some cases. Water can also be manipulated, as the aggressor once was, to help the person regain a sense of control and relaxation- aromas, bubbles, colors, and light refraction, and temperature of the water.
Just like how these qualities of water are able to treat psychogenic pain (Ricciardi, 2013), they can also successfully treat chronic physical pain as well. (Sanchez, 2012) In 2011, a study was conducted at the University of Almeria on a group of patients with pain associated with multiple sclerosis resulted in the following: “50-75% of patients with MS used CAM because it reduces the severity of painful symptoms and offers functional improvement…with no adverse effects”. Even though pain is still subjective and can never truly be accurately measured for research, it is fascinating that such a large amount of people saw improvement in this 20-week program. After 40 sessions, this “aquatic exercise program improves pain, spasms, disability, fatigue, and depression, and autonomy”. Hydrotherapy was used in this study by combining joint/muscle-friendly exercise with deep, synchronized, breathing techniques to gain control of the body and self to conquer pain. Water cushions bodily joints to aid movement while the water relaxes muscles to promote easy movement geared towards pain control. The controlled breathing relaxes the nervous system to improve neuromuscular functioning. PTSD patients are able to benefit from this because of the similar complaints of symptoms prior to the study such as pain, fatigue, depression, and muscular spasms which can diminish autonomy and self-image.
Water therapies are an innovative and unique complementary/alternative treatment; however, it is not right for everyone. Some patients who are burdened by the disorder are a high suicide risk and should not be left unattended submerging in large quantities of water in the event of asphyxiation by drowning. Nevertheless, this is an easy problem to fix if the person is supervised. If the patient does not feel comfortable being watched, this is a normal behavior and shut the door to then room and make sure to constantly listen that the water is still moving. In addition, continue to check on the patient. Also, patients with peripheral vascular issues such as diabetes or cardiovascular disease should not participate in hydrotherapy because it may worsen the condition. In water, these people may also lack the sensory capability to feel the onset of diabetic shock, heart attack, hypotension, hypertension, hypothermia, hyperthermia, and diabetic shock. With this exception, water therapies have the potential to help a large number of people suffering from PTSD.

Post-Traumatic Stress Disorder is an ailment that often results in a challenging life with few close relationships and a lot of pain with little relief. Fortunately, hydrotherapy has been shown to suppress both psychogenic and physical pain while promoting relaxation techniques and channeling anger. The popularity of use is increasing with further research and education because there are no direct negative side effects of use and no adverse reactions. Therapeutic treatments are as cheap as the patient wants them to be, depending on the quality and location of the treatment. Lastly, it helps to provide a foundation for rebirth and growth to start a new and happy life with each breath submerging from the water.