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    Social networking craze connects travel nurses

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    Photos: Getty Images/Photgrapher's Choice RF/Dimitri Vervitsiotis
    Between her full-time job in home care services and her busy family life, Karen O'Hara, RN, BSN, spends about 20 hours a week chatting in discussion groups, hosting online forums, and networking with nurses from around the world.

    "Every day, I log on to see what is happening online—it's addictive," says O'Hara, central intake manager at Mercy Home Health, based in the Philadelphia area.

    O'Hara is among thousands of nurses who have joined the social networking phenomenon. Facebook, MySpace, and Twitter—originally havens for college students—are attracting more and more professionals like nurses. In fact, it's not just nursing students logging on every day. The fastest-growing demographic of social networkers is women age 55 and older.

    Not only are nurses connecting with each other on popular sites like Facebook and LinkedIn, but more than a half-dozen sites have popped up specifically geared toward RNs. The top site is allnurses.com, with more than 398,000 members and 1.9 million visits each month.

    The site includes everything from news, job postings, blogs, discussion forums on clinical and lifestyle topics, and personal profile pages like those on Facebook.

    It's more than just a social chat room like Facebook, explains "Siri," a daily visitor of allnurses.com who prefers to remain anonymous. "When I first came across the site, I didn't think it was for me," Siri says, "but a few years later, I found it again and realized it was nurses trying to impart their knowledge, provide evidence-based practice, and just generally lift up each others' spirits."

    Online explosion

    Brian Short, RN, started allnurses.com when he was in nursing school in the late 1990s and could find very few online nursing resources. He created the Web site as a hobby and included links to nursing sites when he found them. As nurses found his site, they started asking him questions, so he found software that would allow nurses to chat online.

    Short says nurses have written to tell him how much they've learned about nursing through the site. "Nurses should consider information from networking sites in the same way they hear advice from colleagues at their facilities," he says. "It's not meant to be a substitute for medical opinion, but many nurse educators have put our site in their syllabus as required reading."

    Other social networking venues like NurseSpace, the American Nurses Association's (ANA) members-only site, launched more recently. NurseSpace focuses on professional issues, while other sites are even more specialized, as is the case with Nurse Entrepreneur Network, which is aimed toward business-savvy nurses.

    "Nurses share many common experiences, so social networks are really about getting the nurses who are feeling optimistic and active to interact with nurses who are feeling overwhelmed and demoralized so that we can keep everyone up as much as possible," says Jan Rodolfo, RN, national outreach coordinator at the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC) in Oakland, Calif.

    "These sites enable nurses to connect with each other in ways that were not possible decades ago," adds Kenya Haney, RN, president of the National Student Nurses Association (NSNA) in Brooklyn, N.Y. "Nurses of yesterday would have never dreamed of having this type of technology at their fingertips."

    Facebook in vogue

    With more than 350 million users, Facebook is by far the most popular social networking site, followed by MySpace with 130 million monthly users. Members have formed thousands of groups on the sites, many of which nurses have set up.

    One of the more popular nursing groups is called "You Know You're a Nurse When..." which has attracted nearly 120,000 members and features cartoons and humorous material about the profession. "I Am Nurse" is another group that has attracted several thousand members from around the globe. A recent poll on the site asked members how much training they received in their current job on wound care—47 people responded.

    Nurses can even find dating groups specifically for RNs. The most frequented is titled "Ten reasons why you should date a nurse." Then there are pages for nearly every nurse specialty, hobby, religious faith—even fan pages for Showtime's Nurse Jackie, TNT's HawthoRNe, and NBC's Mercy.

    With so many daily visitors, and new groups constantly forming, nursing organizations have recently set up Facebook pages. There were already four "unofficial" Facebook pages for ANA before the organization created its own in July 2009. "Not only did we feel it was important to have an official site, but we wanted to provide a place for nurses to discuss issues about the profession and the association," says Betty Whitaker, ANA's director of membership and marketing.

    Other nursing organizations have also established Facebook pages. A sampling of national groups include the NSNA, American Nephrology Nurses Association, American Psychiatric Nurses Association, National Student Nurses Association, and National Black Nurses Association (NBNA), along with a multitude of state and local nursing groups.

    NBNA President Debra Toney, RN, PhD, explains that the organization is using Facebook as a way to increase its membership. "We want to find out where those pockets of nurses are, and many of them are online, so our board decided that we needed to be on Facebook," she says.

    Rodolfo, a former oncology nurse, led the charge to create a Facebook page for CNA/NNOC. The organization hired her to concentrate on formulating the group's social networking strategy.

    Rodolfo aims to integrate all of the organization's social network channels together, including Facebook, Twitter, Flickr, and YouTube. "Our goal is to help members access information," she says. "We want to be readily accessible, no matter what doorway nurses enter."

    Downsides to networking

    Despite the popularity of social networking sites, there are significant concerns over patient privacy issues. Several recent cases involving nurse's activities on social networking sites have raised complex ethical issues.

    Two nurses with Mercy Walworth Medical Center in Lake Geneva, Wis., were fired after posting pictures of a patient's X-ray on their Facebook pages. Mercy's Vice President Barb Bortner told a local Wisconsin paper that the nurses broke company policy. Authorities are currently investigating whether the nurses also violated the patient's rights and HIPAA rules.

    At the University of Louisville, a nursing student was expelled for her posts on MySpace about her patients, gun rights, and abortion. The university claimed that the nurse broke its code of conduct.

    In retaliation, the student filed a lawsuit against the university, claiming a violation of her freedom of speech. A judge later forced the school to reinstate her.

    Revealing private patient information is the number one misuse of social networking sites. "As advocates for patients and their privacy, all healthcare professionals should have a 'no patient discussion' policy when it comes to social networking sites," Haney says.

    With so many discussions occurring, it's impossible for sites to monitor every conversation for patient privacy violations and other abuses. A staff of volunteers at allnurses.com keeps an eye on posted messages for personal patient information, as well as for inaccuracies.

    "When someone posts something that is nonsense, one of our volunteers will make a note of it or take it off the site," Short says.

    Nurse LinkUp, a smaller social networking site, does not have the staff to watch the discussion boards but relies on members to self-police the site. "People will correct others in forums, or they will report information to us," says Jeremy Feakins, founder and CEO of Nurse LinkUp.

    Experts recommend that nurses consult their employment handbooks for their codes of professional and ethical conduct.

    "Social networking sites mix work and play, and can confuse nurses and their employers because there are many gray areas," Rodolfo says. "But nurses need to use good judgment and take personal responsibility when using social networking sites."








    Modern Medicine NETWORK

    COMMUNITY
    Using social networking sites and other technology, travelers can be closer to home than ever. Read more about maintaining relationships on the road at healthcaretraveler.com/relationships

    NEWS & UPDATES
    New software can automatically destroy electronic communications after a certain time, making them irretrievable. Go to healthcaretraveler.com/vanish to learn about this new technology, which can be used to delete Facebook posts and chat messages.








    Top Nursing Sites

    All Nurses
    allnurses.com
    398,000 members

    This site has been around the longest and is exceptionally active, with thousands of members logged on throughout the day. It contains the most comprehensive resources with discussion boards, news, blogs, job postings, and information by specialties. Introduced in 2009, All Nurses Central focuses on lifestyle issues, including discussions about vacations, pets, religion, movies, and celebrities.

    Nurse's Cafe
    nursescafe.com
    1,000 members
    A basic site has been launched, but contains minimal information to date.

    NurseSpace
    nursingworld.org
    8,000 members
    ANA membership is required to access this site. It looks more like LinkedIn than Facebook, as it focuses mainly on professional rather than lifestyle issues.

    NursingLink
    nursinglink.com
    N/A
    Started by Monster.com, NursingLink mostly provides job posts, networking opportunities and career advice, combined with discussion boards on a variety of topics.

    Nurse LinkUp
    nurselinkup.com
    2,500 members
    This site began in 2007 and calls itself the "nurse social network site," but the discussion boards are not very active and the news section is rarely updated. It has a Facebook page with fewer than 80 fans.

    Nurse Entrepreneur Network
    nurse-entrepreneur-network.com
    200 paid members
    Started in 2005, this site claims to be "the place to go for business solutions for nurse entrepreneurs." Some information is free, but members pay $97 annually to access online classes, articles, worksheets, group coaching, and forums.

    Nurse Together
    nursetogether.com
    70,000 members
    This site includes a career section, information on global nursing, and original articles and advice developed by approximately 100 contributors. The most popular sections are the lifestyle forums. The site recently partnered with Nursefinders, part of Medfinders, to provide a more cost-effective recruitment solution to hospitals for permanent and travel opportunities.








    Pitfalls of Social Networking

    Whether you are already a member of social networking sites or are ready to log on for the first time, remember these six tips to make the most of your experience:

    1. Keep it private. Do not write personal information about yourself, patients, colleagues, or employers that could be easily identifiable. Most social networks have strict privacy policies in place that adhere to HIPAA rules.

    2. Watch what you say. If you post comments on Twitter, your comments are accessible and searchable. With Facebook, even if you have strict privacy settings, your friends may not. The rule of thumb is: If you would be embarrassed if your employer or colleagues read your statements—or saw your pictures—then you're better off not posting them.

    3. Avoid logging on at work. Nurses should avoid using social network sites such as Facebook and Twitter during work time, unless on a formal break. Employers can check when you're posting information to determine if you're conducting personal business during work hours.

    4. Rethink your online picture. The Los Angeles Times has published photos of nurses that the editors obtained from Facebook pages. Don't post profile photos that you would not want to see in print or online. Also, check your facilities' code of conduct for their policy on images of you at work or wearing work uniforms.

    5. Protect your identity. Hackers have infiltrated Facebook by asking people questions that are often used as security questions for bank accounts and credit cards. Unless you know who is asking the questions, refrain from providing personal information.

    6. Be social. Remember that social networking is about being social, so interact with people. Don't just share information about your experiences, interact with others. Joining a social network site is a way to get to know your fellow nurses better and for them to get to know you.