There has been a lot of chatter online recently about the case of a Saskatchewan nurse who has been charged with professional misconduct for comments she made online about her grandfather’s care Healthcare system suffers when health workers are muzzled. Most of the tweets and posts are to the effect that this judgment opposes the freedom of people to share their health care stories or advocate for a better system. I beg to differ.
Certainly nurses, and the general public, can share their stories. Nurses are actually required to advocate for patients, and address incompetence in peers. The question, as I see it, is how do we do that in ways that are both authentic and constructive. We must understand the risks involved in using social media as described by the Canadian Nurses Protective Society InfoLaw: Social Media.
Sharing of health stories is known to be a healing process for many people. As a nurse, I also find that I gain greater understanding of the challenges people face by hearing their stories. There is nothing like telling others what an experience felt like, and being heard. However, there is a fine line between sharing one’s experience, and just being critical. Sharing my experience means saying “we waited several hours in the emergency department, and it was really hard.” Being critical means saying “I was unhappy with the substandard care in the emergency room.”
As soon as we categorize other people’s actions as substandard or incompetent, we have crossed that line into unproductive criticism. When we do it in public we can risk being accused of slander or, as we have seen, professional misconduct. And if we haven’t tried to address our concerns directly with the people involved, then we have strayed into the territory of passive-aggressive conflict style, which is also unproductive. If we rely on online complaining to change the system, we will be sadly disappointed.
As a nurse, I must advocate for the patients and families I work with. I must also respect and attempt to collaborate with my colleagues. This means that I, even more than anyone else, must choose my words carefully if I tell my family’s health story online. There are channels for nurses to address incompetent or unprofessional behaviour of other nurses, and we are obligated to follow those channels. In no way does guarding my words online constitute being “muzzled” or prevented from being an advocate.
It sometimes seems that our social norms about how to manage conflict have changed. We seem to feel we have the right to say whatever we want about others online, without care to how we say it. We think that we are being unfairly restricted if we are held to a standard of behaviour.
I would like us to hold each other to a better standard. When we see a problem in health care, I want us to go to the patient representative, the charge nurse, the health care administration, and strive to work with them for change. When we share our stories, I would like us to describe our experiences without using labels such as “substandard” or “incompetent”. As a nurse, if someone is unhappy with my care, I want them to come to me to resolve it. I don’t want to read about their discontent with me on Twitter.
What seems to be forgotten in the reactions to the Saskatchewan case is that no one is saying nurses or family members can’t talk about their experience. No one is saying we can’t advocate for better health care. But we are being advised to think carefully about HOW we talk about things, HOW we advocate, HOW we live our professional code of ethics in such a way as to address incompetence, advocate for clients, and respect one another all at the same time.
As the customer service saying goes, “If you are happy with our services, tell others. If you are unhappy, tell us so that we can improve”. I would add, “tell us your stories, tell us how you were affected by your experience, and work with us to make things better.”