DiversityNursing Blog

From WorkingNurse.com By Christine Contillo

It’s clear that we’ve not just entered the Information Age — we’ve exploded into it. Information exchange is critical to both the advancement of science and patient care, and the impact of the Internet in the medical field has been enormous. Practitioners are now able to jump the barrier of time and access research findings worldwide; and in nursing it’s caused the creation of an entire subspecialty (nursing informatics) meant to manage the amount of information available.

But nurses studying informatics aren’t he only ones finding ways to improve their skills by surfing the web. According to a survey of the American Academy of Nurse Practitioners, more than 98 percent of nurses responded that they use the Internet or email. The survey continued to ask in what way the Internet was used, and the answers may surprise you.

No More Pencils, No More Books

Beginning with nursing education, students everywhere have access to virtual classrooms and degree programs. Online education means that the limits previously imposed by location and time become less important. Busy students with a computer, or those in the workforce trying to fit school into their already packed schedule, should be able to find a few hours at home for study.

Similarly, many states now require continuing education (CE) for licensing. Nursing needing those hours can get them without leaving home, which in many cases removes important constraints such as child care. Sites such as WorldWideLearn.com allow the student 24/7 access to courses and technical support. Employers can select educational seminars and show them in real time in a conference room or select courses that have been archived for their nurses to watch later.

Nurses were instrumental in developing accredited online continuing education for Wild Iris Medical Education. The company established the site Nursing Continuing Education to help nurses (and other health professionals) across all 50 states fulfill CE requirements. Prices range from free to $65 depending on the individual requirement and number of contact hours offered. Fees can be paid with a credit card — how else? — online.

Podcasts

For those nurses who are pretty comfortable with technology, podcasts are another avenue to investigate. Similar to audio versions of magazines, they can be heard on MP3 players for up-to-date information. Check out PodFeed.net and searching “nursing” or listen to “Nursing Education on the Go” at Podcast Alley.

Streaming Radio

Somewhat similar to podcasts is streaming radio, or radio shows that are available worldwide. AM/FM radio is usually limited by geographical distance, but streaming radio listeners only need access to the web, some free software to download, and a set of speakers.

Barbara Ficarra, RN, BSN, MPA, is a nurse educator in the metro-NYC area and host of “Health in 30,” which airs live at 5:30pm on Fridays on WRCR-AM 1300. Ms. Ficarra lines up expert guests for her weekly show, announces the topic ahead of time, and fields questions as they are phoned in. Without the Internet her show could only be heard locally, but the vast audience afforded by online listeners has enabled her to win wider recognition. In fact, in 2007, she won the Excellence in Journalism award given by the American College of Emergency Physicians.

Blogs

Nursing blogs are web logs and can range from silly to academic. Just as journals are intimate thoughts, blogs can detail nursing practice issues, patient stories, fears, triumphs or even family and leisure activity. Blogs allow nurses to vent their frustrations to their peers and share valuable resources for patient care. Following a few favorites allows you to peer into the mind of the writer. The ability to comment allows you to enter into an electronic relationship that nurses in remote areas may treasure. Certainly information about individual patients must protect their identity, but sharing the means of resolving practice issues helps to improve practice standards everywhere.

Information Sites

According to Family Nurse Practitioner Roseann Neuberg, the impact brought by the Internet to her clinical nursing practice is “huge,” and she identifies it as a valuable source of patient education material. “There are just so many things I can do in terms of patient education,” she says. “I can look up issues or treatments while my patient is sitting right next to me. I can print it up, hand it out, and be sure that they understand what I’m saying before they leave. When I prescribe a medication I can check the price and look for alternatives. I can even use a program to check for drug interactions.”

Tracy Plaskett, a staff nurse at Beth Israel Hospital in New York City, says, “When I get my patient assignment, I’m able to look up any unfamiliar terms in the notes instantly. I can check spellings and make sure that medication orders are correct.”

Ms. Neuberg is quick to point out that she sticks with sites she knows are accurate and updated frequently in order to feel confident that the advice she is giving is sound. Two such sites are UpToDateOnline.com and Epocrates.com, which provide current information about clinical management and treatment of disease. Both require a subscription and password.

Mobile Medicine

Lynda O’Grady, RN, has found another important use of the Internet. Ms. O’Grady is part of a large travel medicine clinic, assessing international travelers who participate in academic programs, sometimes to remote and disease-infested areas. Using special software she’s able to assess their individual medical risks. If she has questions she can access advice from organizations like the Center for Disease Control and the World Health Organization. But what she finds most helpful is her membership in the International Society of Travel Medicine. Through a listserv available only to members she’s able to gain up-to-the-minute answers to questions posed, such as, “Where is the nearest medical clinic to Daar es Salaam?” or, “What do you recommend for altitude sickness for a patient allergic to sulfa?” Thousands of members pose and answer questions for each other, some providing clinical advice that only a person actually living in that area might be able to give.

Support Groups for Patients

Nurses may want to suggest online communities to patients experiencing chronic illness or going through debilitating treatments. Immune-compromised patients may be unable to attend in-person meetings, but staying in touch with a virtual group may allow them to feel less isolated. CancerCare is one professional association that helps organize free groups for patients as well as their caregivers. Virtual communities and forums have been vital to patients sharing treatment experience and offering support to each other.

Consults

The Internet can be used in a novel way for clinical consults. One home care nurse described how she and her colleagues became discouraged trying to evaluate decubiti. When described in the paper chart by different clinicians using different languages or terms it was often difficult to determine if progress was being made. Solution? They used a digital camera to capture an image that could be sent daily via the web to the practitioner. In this case a picture really was worth a thousand words.

Job Searches

Work-related issues can be shared via the Internet. Nurses interested in relocating can do a web search to conduct virtual tours of hospitals they might be interested in, file an application online, get driving directions, or book travel plans through a travel site such as Velocity. When looking to change jobs they can post their resume online. Even low-cost phone communication can be run through Vonage or Skype — both require an Internet connection and headset instead of a phone line or cell phone.

Creating Community

The Internet facilitates a feeling of community and can create the ability to investigate job issues easily. Union members can use online forums to discuss contract negotiation issues, salary, benefits and legal information. New healthcare legislation and practice agreements, as well as regulatory mandates, can be tracked through blog sites. There is just no excuse now for remaining uninformed.

Brian Short, RN, discovered the importance of a nursing community over a decade ago. When Mr. Short was still a nursing student, he created AllNurses.com for the purpose of online support and education. Two years ago the site claimed to cover 400 nursing topics every day and a total of 1.5 million posts. In an interview given at the time of its 10th anniversary, Teresa Burgess, RN, pointed out the importance of the online nursing community for its ability to be used for mentoring and creating a sense of shared purpose.

Let’s end with a word of warning, however, when it comes to using the Internet. While the examples given prove that use of the Internet can be beneficial to nursing practice, we must all bear in mind that much of what we find there remains anonymous and subject to scrutiny.
Our own critical thinking must be used to determine when and how best to use the available information, and to evaluate the value and truth of what we read. Certainly if what we find can nudge us toward being better health professionals, then the monthly cost of Internet service and the time spent in connection with others is well worth it.

The news that some employers have asked for direct access to the Facebook accounts -- including user names and passwords -- of people applying for jobs at their firms has set off a firestorm of controversy.

The reports have raised questions about whether the practice is illegal and if such a policy could expose those employers to potential discrimination lawsuits. The dust-up has even triggered calls by some in Congress for a federal investigation into the practice.

But those recent events only highlight a new reality: The identity that individuals create in the world of social media is quickly becoming an important factor in hiring decisions and in people's broader professional lives.

"The questions around employer access to social network log-ins reflect a broader debate in society about a host of digital privacy issues," says Andrea Matwyshyn, a Wharton professor of legal studies and business ethics. "This is a new concern -- the degree to which employers can gain access to all role identities through one virtual space. There is no parallel to that in the real world."

While the reaction to the practice has been swift and intense, it's hard to predict if it will become a lasting trend.

But, Matwyshyn says, she began hearing about employers requesting access to the Facebook accounts of potential hires as far back as 2008. To date, however, she says, there is no good data on how widespread the practice has become.

The fact that it exists at all is not entirely unexpected: According to Matwyshyn, a number of studies show that most employers look at candidates' online profiles when making hiring decisions, noting a 2011 survey by social-media monitoring service Reppler that found that 91 percent of recruiters report using social-networking sites to evaluate job applicants.

But checking out a publicly available profile on Facebook -- or even asking a job candidate to "friend" someone in human resources at a company where they are applying for a position -- is worlds apart from gaining unfettered access to someone's account through a password.

"If you can take Facebook passwords, what about Gmail passwords?" asks Stuart Soffer, a non-residential fellow at The Center for Internet and Society at Stanford Law School and managing director of IPriori, an intellectual-property consulting firm.

If left unchecked, Soffer says, the practice could expand beyond human resource departments evaluating potential employees.

"What about allowing Facebook access to insurers so they can see what you are saying about your health?" he says. "They could use it as a basis for judging the risk of insuring you."

The request for access to log-in information also raises some serious legal questions.

Clearly concerned about the legal and business implications of privacy breaches, Facebook has come out against the practice, stating that sharing or soliciting a Facebook password is a violation of the company's statement of rights and responsibilities.

"We don't think employers should be asking prospective employees to provide their passwords because we don't think it's the right thing to do," Facebook Chief Privacy Officer Erin Egan says. "But it also may cause problems for the employers that they are not anticipating."

Matwyshyn says employers could be essentially asking job candidates to violate their contract with Facebook if they ask for passwords, creating "an untenable conflict between contract law and employers' perceptions of their own interest in vetting candidates."

In addition, if a Facebook account includes information on an applicant's race or age, for example, that could potentially expose the employer to claims of discriminatory hiring practices. According to Matwyshyn, it is legally hazy whether accessing someone's Facebook account where that information is available is akin to asking it in the interview.

"Arguments can be made that this is a back-door method to gaining information that the prospective employer wouldn't otherwise have access to," she says.

Meanwhile, the issue is getting the attention of Congress. Senate Democrats Charles Schumer and Richard Blumenthal, from New York and Connecticut respectively, have asked the Justice Department and the Equal Employment Opportunity Commission to look into the practice.

But even if it is eventually prohibited or otherwise curbed through legal or legislative channels, Wharton management professor Nancy Rothbard predicts that the use of social media in hiring decisions will continue to be a flashpoint in the years ahead.

"The core of the problem is the blending of personal and professional lives," Rothbard says. "We are still in the infancy of trying to understand how to deal with all this."

Opening the Window -- and Closing a Door?

Just how far employers can legally go to check out job candidates online may not be clear -- but why they are looking for new methods of evaluating applicants is easy to understand, says Wharton management professor Adam Grant.

Research, he says, has shown that the typical job interview is a poor tool for predicting which candidates will succeed. If that does not work, companies need to find something that does.

"Applicants are very motivated to put their best foot forward in an interview," Grant says. "It is very difficult to spot the people who will represent an organization well. But on Facebook, you can see the applicant making day-to-day decisions -- it is a window into how an individual is likely to act."

In fact, recent research has provided evidence that online profiles can be very revealing about specific personality traits.

A paper published recently in the Journal of Applied Social Psychology entitled, "Social Networking Websites, Personality Ratings, and the Organizational Context: More Than Meets the Eye," studied 518 undergraduate students and their Facebook profiles.

The researchers found that the Facebook profiles were a good predictor of the so-called "big five personality traits:" conscientiousness, agreeableness, extroversion, emotional stability and openness. And for a subset of the group where the researchers were able to contact supervisors at companies that had hired those students, there was a correlation between scores on two personality traits -- emotional stability and agreeableness -- and job performance. (SeeHREOnline^TM story here.)

"There is strong evidence that social networking is a valid way of assessing someone's personality," says Donald Kluemper, a professor of management at the Northern Illinois University College of Business and a co-author of the study.

But he says that does not mean there is evidence that an unstructured perusal of a Facebook account will result in better hiring decisions.

"Until a method is validated in a number of ways, including a study of adverse impacts and the legal issues, I wouldn't recommend companies rely on social-networking profiles," Kluemper says.

Now, the use of social-media information is far from fine-tuned, with recruiters typically checking out social media to get a general sense of the person applying for a job or to hunt for any red flags. But it is possible the use of that information could become more sophisticated.

"People are mining that data right now for other purposes, including targeting ads to the right people," says Shawndra Hill, a Wharton operations and information management professor. "It is not out of the realm of possibility to focus that on other outcomes, like how good a match someone is for a job or whether there is a high likelihood they might do something illegal."

While the value of that data may be apparent, it remains to be seen how social media should ultimately fit into some aspects of professional life.

Take the less-controversial practice of managers' friending their colleagues through Facebook. Rothbard says this practice creates numerous potential headaches. Two years ago, she and some colleagues did a series of interviews with 20 people at a variety of levels and in a number of different industries, and found that people were often unnerved friending either bosses or subordinates.

"People felt very uncomfortable with crossing the private and professional boundary when it came to the hierarchy [within an organization]," Rothbard says. "They talked about friending their bosses with similar discomfort and language as they did when they spoke about friending their moms."

Interestingly, Rothbard adds, the rules for social networking in the workplace may differ based on gender.

She led a study of 400 students in which participants were shown Facebook profiles, told that the person was either a boss, a peer or a subordinate, and then asked to rate the individuals based on how likely they were to accept that person's friend request.

The findings: Female bosses with bare-bones profiles were less likely to be accepted than those who revealed more personal information, while the opposite pattern held for male bosses.

"Women who have limited profiles are more likely to be shunned than the women who have a more active presence," Rothbard says. "People see them as cold. But male bosses who reveal less information are more likely to be accepted than those who reveal a lot of information."

The increased scrutiny of people's virtual lives may change the way individuals operate in the social-networking realm.

According to Rothbard, there are essentially four ways of dealing with privacy issues. There are those who control their list of friends carefully, rejecting friend requests from people with whom they don't want to share personal information. Then, there are those who accept virtually all requests, but are very careful about what they post, limiting that content to very safe, less revealing information.

There is also a hybrid approach in which people use privacy settings to share some information with close friends and less-sensitive material with others. And, finally, there is the "let it all hang out" crowd -- those who are comfortable sharing all their information with a large group of close (and not so close) friends.

Grant predicts more people will opt for the more-controlled, filtered approach as they realize their social-media profiles are being scrutinized by potential employers.

"As employers gain this information, so do candidates," Grant points out. "So candidates may use Facebook more carefully and remove the cues that are so valuable [to employers]."

Soffer agrees people will become much more careful about their social-media personas.

"There are ways around this," Soffer says of the unwanted exposure of social-media behavior. "One thing that could happen is people will start having two Facebook accounts." One will be for close friends; the other, a more sanitized version for employers.

But there is always the potential that something posted for viewing by a small group of close friends on Facebook could get out into larger circulation. And for that reason, some argue, the risks of being active in the social-media space outweigh the benefits.

"If you are a CEO, or aspire to be a CEO or director of a public company, I think it makes sense to refrain from social networking," says Dennis Carey, vice chairman at Korn/Ferry International. "There are other ways to communicate with employees and the outside world through properly controlled channels. Some of the messages that are conveyed can be misconstrued or taken out of context by a third party."

The fear of a photo or comment made long ago coming back to haunt you is hardly unfounded. Because sites such as Facebook have been around less than a decade, it is not certain how long someone's social-networking history will remain accessible.

"It is unclear how long the information persists," Hill says. "Firms have different privacy policies, and often privacy policies change over time. While there are policies that allow for deleting data you no longer want on the site, it is hard to guarantee that this information won't live on a database somewhere."

The controversy worries some fans of the social-media revolution.

"I worry that there is already a sense right now that our participation online may come back to haunt us," says Chris Ridder, co-founder of the law firm Ridder, Costa & Johnstone and a non-residential fellow at The Center for Internet and Society at Stanford Law School.

"It inhibits our ability to express ourselves," he says. "If we can only express public relations-like statements, it takes away a good bit of the utility of the Internet. I think it would be a shame if we were to lose the playful aspect of this new technology."

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How would you feel if someone asked for your account information to Facebook or Twitter in an interview? What if your boss did it? Do you think this is a privacy violation? Should there be legislation on this? Let us know in the comments; we want to hear from you!

 

Physicians, nurses, allied health professionals and pharmacists are using social media tools to network with professional colleagues, track down job leads and apply for new positions, according to a new survey.

The survey was conducted by AMN Healthcare, which bills itself as the nation's largest healthcare staffing and workforce solutions company. AMN Healthcare's "2010 Social Media Survey of Healthcare Professionals" was designed to provide healthcare employers and leaders a snapshot of how healthcare professionals are currently using social media and other online applications for networking, job hunting and other career development activities. The survey, which was conducted this fall, received 1,248 responses.

The survey suggests that traditional methods of recruitment such as referrals, online job boards and search engines are not being superseded by social media, whereas social media does surpass other job search methods such as newspaper ads, career fairs and other methods.  At the same time, social networking sites are experiencing tremendous growth, and have become the new frontier in professional networking and career development for physicians, nurses, allied health professionals and pharmacists. Job candidates are spending more time online and experimenting with media sites for job searches, but have thus far found minimal success in securing interviews, job offers and positions.

"It's not surprising that social media and mobile media usage have become additional job sourcing methods for healthcare professionals and a way to network with peers and companies," said Susan Salka, AMN's president and CEO. "What this tells us is that job seekers will add new methods and continue to replace those that don't work as they have access to innovative new resources. As the nation's largest healthcare staffing company, we find this information valuable in being able to connect with top talent in healthcare today. It will be interesting to compare this year's results with those from 2011 and beyond to gauge the search methods and developing preferences of job seekers."

Key survey findings:

    Thirty-eight percent of clinicians surveyed are currently seeking employment, and 12 percent of current job seekers have been looking for more than a year.
    Nurses have had a significantly shorter job search than their fellow professionals, averaging three months, compared to just less than seven months for physicians and allied professionals, and nine months for pharmacists.
    Thirty-seven percent of clinicians reported using social media for professional networking; nurses had the highest use among healthcare workers at 41 percent.
    Ten percent of healthcare professionals are using mobile job alerts, but only 3 percent have received an interview, 2 percent have received a job offer and 1 percent secured a new job.
    Physicians are by far the heaviest users of mobile devices for professional reasons among their medical colleagues; 37 percent used healthcare-related applications and 17 percent used mobile devices for healthcare-related content or jobs.
    Sixty-four percent of the clinicians surveyed would choose Facebook, the clear favorite, if they could choose only one social networking site.

Time spent and social sites visited outpace other US internet user groups

US Hispanics are more active on social media than the average US internet user, and are logging in more frequently to a wider variety of social sites.

The February 2012 “American Pulse Survey” from BIGinsight of US adult internet usage found that, while greater percentages of black internet users spent larger blocks of time online than the other groups studied, Hispanic internet users spent more of their online time on social media sites.

On an average day, 26.8% of Hispanic internet users spent six hours or more on social media sites, while 20.4% of black internet users and only 8.5% of total internet users spent that much time on social sites.

Looking specifically at which sites social-savvy Hispanics were using, the survey found US Hispanics were willing to participate in some newer and smaller social sites, logging in more often to networks like Pinterest, foursquare and LinkedIn, for example, than the average US internet user.

In the case of LinkedIn, 15.5% of US Hispanic internet users logged in to that site at least once a day, compared to 10.9% of black internet users and 4.9% of white ones. And, while 85% of white and 82.7% of black internet users reported not having an account on Pinterest, that number dropped to 71.5% among Hispanic internet users.

As marketers work to reach these active Hispanic internet users, data about which social sites Hispanics prefer and their frequency of use can be key to understanding where and when to connect with these consumers.

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